The trend of tuberculosis case notification and predictors of unsuccessful treatment outcomes in Samdrup Jongkhar district, Bhutan: A fourteen-year retrospective study

Background Regardless of the advancement in medical technologies, the diagnosis of tuberculosis (TB) in children has remained a challenge. Childhood TB is rampant and an important cause of morbidity and mortality. The objective of this study was to determine the trend of TB and treatment outcomes in children aged ≤14 years registered for TB treatment under DOTS course in three districts of Sindh, Pakistan. Methods For this retrospective study, records of TB children (≤14 years) registered for the treatment of TB from January 2011 to December 2015 in three districts of Pakistan, were collected. Demographic data, baseline weight, clinical manifestations, radiography, histopathology results and treatment outcomes were collected from TB unit registers. Results A total of 2,167 children were treated for TB during the study period. Of these, 1,199 (55.3%) were females and 1,242 (57.3%) were from urban areas. Over three-quarter of patients (76.9%) had pulmonary TB with 13.3% of sputum smear positive cases. The overall treatment success rate was 92.4%. In multivariate analysis, rural residents (OR: 2.146, p < 0.001), sputum smear positive cases (OR: 3.409, p < 0.001) and re-treated patients (OR: 5.919, p < 0.001), were significantly associated with unsuccessful treatment outcomes. However, age group ≤2 years, male and those who were underweight were found to have the highest risk of pulmonary tuberculosis (OR: 1.953, p < 0.001; OR: 1.262, p = 0.028; OR: 1.342, p = 0.008), respectively. Conclusion Patients at risk of treatment failure must be given particular attention. Moreover, strategies are needed to further improve the diagnosis and treatment of TB among children and improve the recording system.

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A retrospective study on Tuberculous Lymphadenitis; A retrospective finding from multicenters referal hospitals

10.21203/rs.3.rs-15640/v1 ◽

2020 ◽

Author(s):

Syed Ghouse Mohiuddin ◽

Siti Maisharah ◽

Orwa Albitar ◽

Muhammad Shahid Iqbal ◽

Amer Hayat Khan

Keyword(s):

Retrospective Study ◽

Treatment Outcomes ◽

Univariate Analysis ◽

Clinical Manifestations ◽

P Value ◽

Tuberculous Lymphadenitis ◽

Age Group ◽

Early Management ◽

Unsuccessful Treatment ◽

Multiple Variables

Abstract Background Extra-pulmonary tuberculosis (EPTB) represents about 14% of all cases of tuberculosis (TB) in Malaysia. The aims of the study include evaluation of socio-demographic factors, clinical manifestations, co-morbidities among patients with Tuberculous Lymphadenitis and their treatment outcomes.Methods The retrospective study was conducted from 2006 to 2008. Data on socio-demographic along with histopathological results were collected. Signs and symptoms were also recorded from TB registers, treatment cards and TB medical personal files using standard data collection tool. Among multiple variables significant factors identified by univariate analysis, were included in multivariate logistic regression to estimate the odds ratios (ORs) with the 95% confidence intervals (CIs). The statistically significant p value was considered as < 0.05.Results There were 348 (57%) males and on the other hand 262 (43%) females which shows almost equal incidence rate of Lymphadenitis in both genders. Mean age was found as 34.3 ± 14.6 years were majorly reported with positive diagnosis. 196 (32.1%) Malay was found with Tuberculous lymphadenitis followed by Chinese population of 148 (24.3%). Geographically from 386 (63.3%) urban population were found positive for lymphadenitis and over 224 (36.7%) of rural region. treatment outcome was observed 444 (72.8%) with successful treatment. WHO states the types of treatment failures and accordingly 85 (13.9%) patients were continued with the therapy that can be due to non-compliance or relapse of Tb. Among unsuccessful outcomes 194 patients of age group 26 -35 years, 65 (33.5%) were reported and 38 (29.7%) patients out of 128 between 16 – 25 years. Blood results showed erythrocyte sedimentation rate greater than 10 in 280 (45.9%) patients. Therefore, among 280 there were 115 (41.1%) patients found to have unsuccessful treatment showing strong association with p-value of <0.001.Conclusion Finding signifies that effect of weight loss on poor treatment outcomes` and active screening measures for patients with comorbidities are therefore recommended in patients with Tb lymphadenitis along with improvements in the diagnosis and early management of co-morbidities complications. As young age group were found to have poor or unsuccessful treatment outcomes and required aggressive strategy together with educating patients can further increase the treatment success rate.

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Tuberculosis (TB) in the Refugee Camps in Ethiopia: Trends of Case Notification, Profile, and Treatment Outcomes, 2014 to 2017

10.21203/rs.3.rs-52830/v1 ◽

2020 ◽

Author(s):

Tsegay Legesse ◽

Goitom Admenur ◽

Selemawit Gebregzabher ◽

Eyob Woldegebriel ◽

Bexabeh Fantahun ◽

...

Keyword(s):

Treatment Outcomes ◽

Data Extraction ◽

Treatment Success ◽

Refugee Camps ◽

Success Rates ◽

Factors Associated ◽

Unsuccessful Treatment ◽

Economic Support ◽

Childhood Tb ◽

Case Notification

Abstract Background: Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to evaluate the effectiveness of TB programs. This study aimed to determine trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. Methods: This retrospective cohort study was conducted from October 2018-June 2019. Demographic and clinical data of all TB cases registered from 2014 to 2017 in 25 refugee camps located in seven refugee areas (Shire, Afar, Gambella, Asossa, Mizam, Jijiga, and Dollo Ado) were extracted using pre-tested data extraction format. Multivariate logistic regression was performed to calculate odds ratios and 95% confidence intervals for factors associated with unsuccessful outcomes.Results. A total of 1553 TB cases, mean age 27.7 years, were registered (2014-2017). Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in the number of notified TB cases (138 to 588 cases), in the percentage of EPTB (23.2% to 32.7%), bacteriologically confirmed pulmonary new and relapse (43.8% to 64.8%), and contribution of children to total TB cases (18.8% to 30.1%) and to EPTB (40.6% to 65.1%). Treatment success rates for all TB cases remained lower at 72.7%-79.4% (on average 11.7% were not evaluated, 8.0% lost to follow-up (LTFU), 4.8% died, and 0.5% failed). Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive.Conclusions: This study has provided valuable evidences that can help to improve the TB programs. There was increased trend in number of notified TB cases, and in proportion of EPTB, childhood TB, and bacteriologically confirmed pulmonary new and relapse cases. Treatment success rate (2014-2017) was far below global target (90%), and “not evaluated” and LTFU treatment outcomes were higher, which need to be improved. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives who at risk for unsuccessful treatment.

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Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective Study In Jos North And Mangu, Plateau State, North - Central Nigeria

10.21203/rs.2.11227/v2 ◽

2019 ◽

Author(s):

Comfort Nanbam Sariem ◽

Patricia Odumosu ◽

Maxwell Patrick Dapar ◽

Jonah Musa ◽

Luka Ibrahim ◽

...

Keyword(s):

Retrospective Study ◽

Treatment Failure ◽

Treatment Outcomes ◽

Treatment Success ◽

Infectious Agent ◽

Tuberculosis Treatment ◽

Patient Treatment ◽

North Central ◽

Unsuccessful Treatment ◽

Plateau State

Abstract Background Tuberculosis (TB) disease is the leading cause of death from a single infectious agent globally. Medication adherence will be more valuable if it improves clinical/treatment outcomes of the patient because treatment outcomes are major indicators for evaluating TB therapy. Objective To examine a fifteen-year record of tuberculosis treatment outcomes in Jos North and Mangu Local Government Areas of Plateau State. Methods The retrospective registry based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State, North-Central Nigeria. Data were collected from 10,156 TB patient’s health records from 2001 to 2015. Treatment outcomes were classified as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). Analysis was done descriptively and factors associated with treatment outcomes were determined using multiple logistic regression with the aid of Stata version 11. Results Males were 58.1% of the population (10,156). Mean age ±SD was 35.5±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment; sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes from 83.8% to 64.4%, with a corresponding increase in unsuccessful treatment outcomes was observed. After adjusting for sex, and TB category, being HIV positive was 2.8 times (95% CI: 1.11-6.83, p =0.028) more likely to be associated with treatment success than having an unknown status. TALF/RAD, relapse and MDR-TB were less likely associated with treatment success than newly diagnosed TB patients Conclusion Underlying reasons for medication non-adherence and treatment failure identified should be resolved by the patient, treatment supporter and health system through adherence counseling, increased education on voluntary counseling and testing of HIV among TB patients. Keywords: Tuberculosis, Treatment Outcomes, Retrospective Study, Nigeria

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Reflecting on tuberculosis case notification and treatment outcomes in the Volta region of Ghana: a retrospective pool analysis of a multicentre cohort from 2013 to 2017

Global Health Research and Policy ◽

10.1186/s41256-019-0128-9 ◽

2019 ◽

Vol 4 (1) ◽

Author(s):

Eric Osei ◽

Samuel Oppong ◽

Daniel Adanfo ◽

Bless Ativor Doepe ◽

Andrews Owusu ◽

...

Keyword(s):

Success Rate ◽

Treatment Outcomes ◽

Treatment Success ◽

World Health ◽

Treatment Success Rate ◽

Unsuccessful Treatment ◽

Treatment Interruptions ◽

Incidence And Mortality ◽

Volta Region ◽

Case Notification

Abstract Background Tuberculosis (TB) remains a petrified condition with a huge economic and health impact on families and health systems in Ghana. Monitoring of TB programme performance indicators can provide reliable data for direct measurement of TB incidence and mortality. This study reflects on the trends of TB case notification and treatment outcomes and makes comparison among 10 districts of the Volta region of Ghana. Methods This was a retrospective analysis of surveillance data of a cohort of TB cases from 2013 to 2017. Trends of case notification and treatment outcomes were examined and compared. Logistic regression was used to determine the independent relationship between patients and disease characteristics and unsuccessful treatment outcomes. Odds ratios, 95% confidence intervals and p-values were estimated. Results A gradual declining trend of case notification of all forms of TB was noticed, with an overall case notification rate (CNR) of 65 cases per 100,000 population during the period. A wide variation of case notification of TB was observed among the districts, ranging from 32 to 124 cases per 100,000 population. Similarly, treatment success rate decreased slightly from 83.1% during the first year to 80.2% in 2017, with an overall treatment success rate of 82.5% (95% CI: 81.3–83.8%). Treatment failure, death, and lost to follow up rates were 0.8% (range 0.5–1.2%), 13.5% (range 12.4–14.7%), and 3.1% (range 2.6–3.8%) respectively. The treatment success rate among districts ranged from 70.5% in South Tongu to 90.8% in Krachi West district. Returned after treatment interruption (Adjusted odds ratio [AOR]: 3.62; 95% CI: 1.66–7.91; P < 0.001) and TB/HIV co-infection (AOR: 1.94; 95% CI: 1.57–2.40; P < 0.001) predicts poor treatment outcomes. Conclusion Over the past five years, TB case notification and successful treatment outcomes did not significantly improve. Wide district variations in CNR was observed. The overall treatment success rate observed in this study is below the target of > 90% set by the World Health Organization’s (WHO) end TB strategy. Additionally, patients who returned to continue treatment after interruption and those who were co-infected with HIV strongly predict unsuccessful treatment outcomes. Sustained interventions to prevent treatment interruptions and improved management of co-morbidities can enhance treatment outcomes, as required to achieve the elimination goal.

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Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017

BMC Infectious Diseases ◽

10.1186/s12879-021-05828-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tsegay Legesse ◽

Goitom Admenur ◽

Selemawit Gebregzabher ◽

Eyob Woldegebriel ◽

Bexabeh Fantahun ◽

...

Keyword(s):

Treatment Outcome ◽

Treatment Outcomes ◽

Treatment Success ◽

Refugee Camps ◽

Success Rates ◽

Continuous Increase ◽

Unsuccessful Treatment ◽

Childhood Tb ◽

Measure Of Association ◽

Case Notification

Abstract Background Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to improve the effectiveness of TB programs. This study aimed to investigate trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. Methods In this retrospective cohort study, demographic and clinical data of all TB cases registered in 25 refugee camps in Ethiopia from January 2014 to December 2017 were extracted. Multivariate logistic regression was fitted to estimate odds ratios and corresponding 95% confidence intervals for the measure of association linked with factors significantly associated with unsuccessful treatment outcomes. Results A total of 1553 TB cases, mean age 27.7 years, were registered from 2014 to 2017. Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in number of notified TB cases (138 to 588 cases), in percentage of EPTB (23.2 to 32.7%), in contribution of children to total TB cases (18.8 to 30.1%) and to EPTB (40.6 to 65.1%), and in proportion of bacteriologically confirmed new and relapse pulmonary cases (43.8 to 64.8%). Treatment success rates for all TB cases remained lower at 72.7–79.4%. On average 24.8% had unfavorable treatment outcome, including 11.5% not evaluated, 8.0% LTFU, 4.8% died and 0.5% treatment failed. Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive. Conclusions There was continuous increase in notified TB cases and in percentage of childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases increased overtime. TB treatment success remained lower than the national achievement in 2017 (96%) and global target (> = 90%), which needs improvement. The higher LTFU, not evaluated, and death suggests the need to strengthen adherence education and supervision. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives.

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