Treatment outcomes of tuberculosis patients in a Directly Observed Treatment Short course (DOTS) Referral Centre in Delta State, Nigeria: a five-year review (2012 - 2016)

Introduction: The objective of this study is to observe the trend in treatment outcomes and identify determinants of treatment success among patients recruited into care through the DOTS strategy. Methodology: A retrospective record review of tuberculosis patients (2012-2016) was carried out at the Tuberculosis and Leprosy Referral Centre, Eku, Delta State, Nigeria. Results: Records of four hundred and twenty five (425) tuberculosis patients under DOTS were reviewed over five years. The highest number of cases under treatment, 102 (24.0%), was recorded in 2013. The mean age (SD) of patients was 37.3 (±16.5) years, majority of the patients were male (62.4%) and 18% had TB/HIV co-infection. Treatment outcomes of patients were cured (53.4%), completed (27.8%), died (6.8%), failed (2.4%), lost to follow up (4.9%), transferred out (1.2%) and not evaluated (3.5%). Over all, treatment success rate was 81.2% with a trend of 88.7% (2012), 87.3% (2013), 85.9% (2014), 65.0% (2015) and 65.8% (2016) respectively. Patient characteristics were not associated with treatment success.Conclusion: The treatment success rate was high and in line with the national recommendation of 80% and above. The trend showed a reduction in number of new cases enrolled into the DOTS programme, reduction in success rate with a concomitant increase in loss to follow up. There was no association between patient characteristics and TB treatment success. System strengthening on patient follow up, community health education and treatment adherence is recommended. Keywords: Tuberculosis; DOTS; Treatment Outcome; TB/HIV Co-infection; Delta State

Respiratory symptoms and ventilatory functions among quarry workers in Edo state, Nigeria

Introduction: Workers in the quarry industries are exposed to hazards resulting from the inhalation of air borne particulates. The study determined the prevalence of respiratory symptoms and assessed ventilatory functions among quarry workers in Edo state, Nigeria Methods: Quarry workers (site workers and office workers) were interviewed using structured questionnaire. FEV1, FVC, FEV1/FVC and PEFR were measured using a KoKo Legend spirometer. Results: A total of 113 quarry workers (76 exposure and 37 controls) were studied. The exposure group had significantly higher occurrence of chest tightness (35.5%) compared with 16.2% of the controls (p < 0.05). The occurrence of cough (23.7% versus 13.5%), sputum (21.1% versus 16.2%), and dyspnoea (7.9% versus 5.4%), were higher in exposure groups while wheeze (10.8% versus 10.5%) and nasal congestion (27.0% and 25.0%) were higher in the control groups. The mean (SD) FEV1, and FVC were significantly lower among the exposure compared with the control group; 2.77L (0.73) versus 3.14L (0.78), p < 0.05, and 3.48L (0.84) versus 3.89L (0.92), p < 0.05. In both groups, smokers had significantly lower mean (SD) FEV1, FVC and PEFR compared with non-smokers; 2.91L (0.77) versus 3.39L (0.69), p = 0.01, 3.61L (0.91) versus 4.26L (0.74), p < 0.05 and 6.56L (2.43) versus 7.98L (1.67), p < 0.05. Conclusion: Chronic exposure to quarry dust is associated with respiratory symptoms and reduced lung function indices among quarry workers. The enforcement of the use of PPEs and periodic evaluation the lung function status of quarry workers is advocated.Pan African Medical Journal 2016; 2