Date of Conferral

4-4-2025

Date of Award

April 2025

Degree

Ph.D.

School

Public Health

Advisor

Harrison Ndetan

Abstract

An estimated 40% of people with tuberculosis (TB) are missed due to underdiagnosis, and among those previously treated TB cases, about a quarter develop drug-resistant TB in Nigeria. The emergence of multi-drug-resistant TB (MDR-TB) is stalling the effort towards TB’s control and eradication. Few studies have examined the impact of the psychosocial effect and support systems for TB, particularly for MDR-TB. In this quantitative, cross-sectional study, the predictive relationship between social support given to MDR-TB patients and their treatment outcomes was examined using secondary data of 594 MDR-TB cases enrolled between January 2018 and December 2021. The theoretical framework for this study was grounded in the social-ecological model. Multiple logistic regression was used to determine if a statistically significant predictive relationship exists between treatment outcome and social support while adjusting for sociodemographic factors (age, gender, place of residence, education, marital status), HIV status, and antiretroviral therapy (ART) status among MDR-TB, and persons with HIV in Nigeria. After adjusting for the sociodemographic factors and HIV status, the result was indicative of a statistically significant 728% increased odds of the likelihood of reporting favorable treatment outcomes for MDR-TB among those with social support compared to those without in Nigeria (aOR= 7.277, 95% CI= (1.369 – 38.679), p = 0.02). The sample was limited in size among those with HIV, and as such, the results cannot be replicated due to sparse data. This finding justifies the need to ensure social safety nets and upscale the quality of social support services in a patient-centered approach to meet the needs of the vulnerable population for positive social change.

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