Economic support intervention improves tuberculosis treatment outcomes in rural Nigeria.

SETTING: A secondary care hospital in rural Nigeria.

OBJECTIVE: To investigate the feasibility of providing financial incentives to tuberculosis (TB) patients under routine conditions, and to determine their impact on TB treatment outcomes in a low-resource setting.

DESIGN: A prospective, non-randomised intervention study.

RESULTS: A total of 294 TB patients (respectively 173 and 121 in the control and intervention periods of 3 months' duration each) were registered in the study. The patients did not differ in terms of their demographic or clinical characteristics (P not significant). The treatment success rate was 104/121 (86.0%) during the intervention, and 123/173 (71.1%) during the control period (P = 0.003). The proportion of patients who were lost to follow-up significantly decreased during the intervention period (20.2% vs. 5.0%, P <0.001). There were no differences in deaths (P = 0.8) or treatment failure rates (P = 0.5) in the intervention and control periods. There was also no difference in the rate of sputum smear conversion after the intensive phase of treatment (88.1% vs. 91.5%, P = 0.5). Independent determinants of treatment success were female sex (adjusted odds ratio [aOR] 1.9), human immunodeficiency virus negativity (aOR 2.5) and receiving financial incentives (aOR 2.3).

CONCLUSIONS: Financial incentives proved to be effective in improving treatment success and reducing loss to follow-up among poor TB patients in Nigeria.