Trends and treatment outcomes of tuberculosis and associated factors among patients in Dawe Kachen District: a five-year health facility registry analysis

Ethiopia is among the countries with a high tuberculosis (TB) burden and has implemented the World Health Organization (WHO)-recommended Directly Observed Treatment Short-Course (DOTS) strategy since 1991. In Dawe Kachen District, a previous retrospective study (2013–2018) assessed TB treatment outcomes but did not examine the associated factors. Moreover, no subsequent studies have been conducted in the district, creating an important evidence gap. This study assessed TB trends, treatment outcomes, and associated factors among patients registered at three DOTS-providing health facilities (Mio, Sofumar, and Fursa) in the Dawe Kachen District from 2018 to 2022. TB cases likely include both drug-sensitive and drug-resistant forms, as resistance status was not recorded in the registers. Data were extracted from TB registration books for 399 patients using a structured data collection form. Information on treatment year, socio-demographic characteristics, and clinical variables was collected. Binary logistic regression analysis was performed using STATA version 14 to identify factors associated with treatment success. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated, and statistical significance was set at p < 0.05. Males accounted for 64% of TB cases, while individuals aged 15–44 years represented 46%. Pulmonary TB (PTB) constituted 95.2% of cases, of which 93.7% were smear-positive. Most patients (91%) were newly diagnosed cases, and all were HIV non-reactive. The number of TB cases declined from 112 (28%) in 2018 to 53 (13%) in 2022. Treatment outcomes showed a success rate of 82.7%, with death, loss to follow-up, treatment failure, and transfer-out rates of 4.1%, 8.3%, 3.0%, and 2.0%, respectively. Male patients were significantly more likely to achieve treatment success than females (AOR = 2.60; 95% CI: 1.53–5.40; p < 0.05). Patients within 15–44 years were also more successfully treated than those ≤ 14 years (AOR = 1.21; 95% CI: 0.36–4.24; p < 0.05). TB cases declined steadily during the study period. However, the overall treatment success rate remained below the WHO target of 90%. The high proportion of new TB cases suggests ongoing transmission within the community, highlighting the need to strengthen TB prevention, control, and treatment programs in the district.