Grant: Travel Awards - Institute Community Support

Background: Tuberculosis remains the 9th leading cause of death worldwide with 1.67 deaths in 2016. This is despite the fact that most people who develop TB disease can be cured if they are diagnosed and treated early on the correct treatment. Although DRTB survival rates are lower and treatment more difficult, evidence shows that response and survival, as well as infection transmission, are positively impacted by treatment within 4 weeks of diagnosis, as mortality rate is highest within the first month of diagnosis. We focus on whether diagnosed patients are placed on treatment and the timeliness of treatment initiation (early treatment benchmarked at one-month post-diagnosis), for patients diagnosed with DRTB. Methods: We conducted a retrospective cohort study using diagnosis and treatment data from the Nigerian National TB program for 2015. Our primary outcomes were treatment received and timely treatment. We compared certain systemic and patient characteristics between these groups. Results: Our sample included 998 diagnosed patients, age ranging from 0-87 with a median of 34 years, out of which 48.2% were untreated. Of those treated, 49.1% were placed within 30 days. Further statistical analysis showed that patients in certain geopolitical zones were less likely to be treatment enrolled. Using December as a reference group, patients diagnosed in March were more likely to be placed on treatment. Early treatment initiation (within 30 days) was less likely in clinically diagnosed patients and those initiated in the community. Conclusions: Timely access to diagnosis and treatment services are critical to DRTB patients' survival and treatment outcomes. However, disparities persist in access to services. The National TB Program should promote prompt diagnostic procedures and timely treatment initiation for DRTB patients across different geopolitical zones, while putting in place measures to reduce barriers.