Treatment outcomes and predictors of unfavourable response among tuberculosis patients in Sokoto State, Nigeria (2020–2024)

Tuberculosis (TB) remains a leading cause of death globally, with Nigeria ranking sixth among high-burden countries. While programmatic reports from Sokoto State claim a 97% treatment success rate, independent evaluations are lacking. This study assessed TB treatment outcomes and identified predictors of unfavourable outcomes in Sokoto State from 2020 to 2024. A descriptive cross-sectional design was employed, involving 200 respondents comprising health workers (40.0%), TB patients (27.5%), and public health officers (32.5%). Data were collected using structured questionnaires and patient record reviews. Treatment outcomes were categorized according to WHO definitions. The overall treatment success rate was 80.0% (65.0% cured, 15.0% completed), significantly below the 85% WHO target. Default rate was 10.0%, mortality 5.0%, treatment failure 2.5%, and transfer-out 2.5%. TB predominantly affected males (59.0%) and adults aged 30-49 years (52.5%), with 32.5% having no formal education. Pulmonary TB was most prevalent (79.0%). Stigma/discrimination (36.0%) and poor awareness/health education (30.0%) were the most significant barriers. Concurrent research documented 83.3% underweight prevalence, 68.7% acute malnutrition, 91.3% vitamin A deficiency, and 78.0% systemic inflammation among under-five children, conditions that compromise immune function and adversely affect TB outcomes. Sokoto State is not on track to meet 2030 End TB Strategy targets. The discordance between programmatic claims (97%) and independent evaluation (80%) highlights the need for improved surveillance and patient support systems. Addressing stigma, enhancing awareness, strengthening follow-up, and tackling the malnutrition-inflammation syndemic are critical to improving outcomes.