scholarly journals 1342. Impact of HIV Infection on Treatment Outcome of New Tuberculosis Patients Attending Tuberculosis and Antiretroviral Treatment Services in the Community-Based Hospital, Thailand: A Retrospective Cohort Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S485-S486
Author(s):  
Subencha Pinsai
Keyword(s):  
Cohort Study ◽  
Treatment Outcome ◽  
Hiv Infection ◽  
Success Rate ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Factors Associated ◽  
The Impact

Abstract Background Tuberculosis (TB) and HIV are one of the significant public health problems in Thailand, and an estimated 15,000 individuals have a dual infection. Both HIV and TB each disease speeds up the progression of each other. TB is the leading cause of death in HIV-infected individuals, and HIV coinfected TB patients have disease-specific, and treatment affected their treatment outcomes. There is insufficient evidence on issues of TB and HIV co-infection patients received treatment. This study aimed to assess the impact of HIV status on treatment outcome of TB patients. Methods We conducted a retrospective cohort study among TB patients who registered to service at Chaophraya Abhaibhubejhr Hospital, Prachin Buri, Thailand from October 1, 2017 to October 31, 2018. All patients’ demographic data, diagnosis, and treatment were retrieved. Clinical characteristics, treatment outcome, and factors associated with treatment outcome were analyzed. Results There were 49 (10.65%) HIV among 460 TB patients with a median (IQR) age of 44 (32–61) years old and 65.2% were males. Disseminated TB and extrapulmonary TB were higher in HIV coinfected group (P < 0.001). All pulmonary TB patients’ lower lobe involvement was higher in HIV coinfected group (62.50 vs. 36.00, P = 0.001). In HIV coinfected group median CD4 was 134 cell/mm3 (IQR 19–294), 66.67% were diagnosed HIV infection after TB diagnosis, the median time from TB diagnosed to antiretroviral was 29 days (IQR 21–48). The overall treatment success rate was 93.04%; the treatment success rate was similar in HIV coinfected TB patients (89.80%) and non- HIV-infected patients (93.43%) (P = 0.66).Adverse drug reactions were higher in HIV coinfected group (44.89% vs 12.41%) (P < 0.001). By multiple stepwise logistic regression, factors associated with anti-TB drug adverse reactions were having HIV infection (OR 7.99; 95% CI 3.73–17.10, P < 0.001), Age >60 years (OR 2.64; 95% CI 1.43–4.87, P = 0.002) and female sex (OR 1.97; 95% CI 1.11–3.52, P = 0.02). Conclusion There is a high TB treatment success rate among patients who have treated for TB, but adverse drug events in HIV co-infected TB patients is higher than that observed in non-HIV-infected patients. Disclosures All authors: No reported disclosures.

scholarly journals Factors Associated With Treatment Outcome in Patients With Nontuberculous Mycobacterial Pulmonary Disease: a Large Population-based Retrospective Cohort Study in Shanghai

2021 ◽  
Author(s):  
Li Ping Cheng ◽  
Shan Hao Chen ◽  
Hai Lou ◽  
Xu Wei Gui ◽  
Xiao Na Shen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Treatment Outcome ◽  
Treatment Failure ◽  
Pulmonary Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Bacterial Species ◽  
Treatment Success ◽  
Middle Aged ◽  
Factors Associated

Abstract Background: Investigate factors associated with treatment outcome in patients with nontuberculous mycobacterial pulmonary disease (NTMPD). Methods: This retrospective cohort study examined NTMPD patients in Shanghai from January 2014 to December 2018. The distribution and incidence of the different causative species were determined. The outcomes of patients infected with different NTM species were compared. Univariate and multivariate binary logistic regression analyses were used to determine the odds ratios (ORs) and 95% confidence intervals (CIs) for the association of different factors with treatment failure. Results: The most common species were Mycobacterium avium complex (MAC) (50%), M. abscessus (28%), and M. kansasii (15%). Over five years, the proportions of M. kansasii and M. abscessus increased, and that of MAC decreased. The treatment success rate was significantly greater for patients infected with M. kansasii (89.9%) than MAC (65.0%, P<0.001) and M. abscessus (36.1%, P<0.001). Multivariate analysis indicated the risk factors for treatment failure were pathogenic NTM species (M. abscessus: aOR=9.355, P<0.001; MAC: aOR=2.970, P=0.021), having an elevated ESR (>60mm/h: aOR=2.658, P<0.001), receipt of retreatment (aOR=2.074, P<0.001), middle-aged and elderly (>60 years-old: aOR=1.739, P=0.021; 45–60 years-old: aOR=1.661, P=0.034). Conclusions: The main bacterial species responsible for NTMPD infections in Shanghai were MAC, M. abscessus, and M. kansasii. Patients with M. kansasii infections had a higher rate of treatment success. Multiple factors including infection by M. abscessu or MAC, an elevated ESR, receiving retreatment, middle-aged and elderly were associated with treatment failure.

scholarly journals Pulmonary Tuberculosis: Treatment Outcomes and Factors Associated with Poor Treatment Outcome in Pahang, Malaysia

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Zafirah Amalina binti Zulkipli ◽  
Muhammad Amir Hafiz bin Mohd Salleh ◽  
Musaab Nassereldeen Ahmed
Keyword(s):  
Logistic Regression ◽  
Treatment Outcome ◽  
Pulmonary Tuberculosis ◽  
Success Rate ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Health Concern ◽  
Multiple Logistic Regression ◽  
Factors Associated

Introduction: Tuberculosis (TB) remains a formidable public health concern in Malaysia. Malaysia’s national treatment success rate is still below the ideal 90% positive outcome recommended by the End TB Strategy (2015-2035). In this study, we evaluated the treatment outcomes and associated predictors of smear or culture positive pulmonary tuberculosis (PTB) patients. Materials and Methods: This is a retrospective cohort study conducted in chest clinic of Hospital Tengku Ampuan Afzan (HTAA), Pahang from January 2012 to December 2016. PTB cases in HTAA were crosschecked with TB registry and patients who fulfilled the inclusion criteria were selected. Data was collected using a standardized clinical report form and analyzed using multiple logistic regression. Results: There were a total of 342 patients recruited. Majority were Malaysian (94.2%), male (67.8%) and Malay (80.0%). The treatment success rate was 55.26%, with a cure rate of 42.98%. The high portion of defaulters (21.05%) in our study population was amongst the most striking findings. Multiple logistic regression analysis revealed that the factors associated with unfavourable treatment outcome were time in treatment, case after treatment interruption or failure and poor compliance. Univariate analysis revealed that male, hepatitis, smoking and intravenous drug user were found to be significant factors associated with poorer treatment outcomes. Conclusion: Achieving a higher patient retention rate is a significant factor in increasing effectiveness of treatment services. Thus, our study recommends stricter Directly Observed Treatment, Short Course (DOTS) and an enhanced understanding of the real barriers to patients’ treatment regimen adherence in order to overcome them.

scholarly journals Treatment success and mortality among adults with tuberculosis in rural eastern Uganda: a retrospective cohort study

2020 ◽  
Author(s):  
Jonathan Izudi ◽  
Imelda K. Tamwesigire ◽  
Francis Bajunirwe
Keyword(s):  
Mortality Rate ◽  
Hiv Infection ◽  
Success Rate ◽  
Treatment Outcomes ◽  
Successful Treatment ◽  
Retrospective Cohort ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Reduce Mortality Rate ◽  
Eastern Uganda

Abstract Background: Successful treatment of tuberculosis leads to clinical and public health benefits such as reduction in transmission, complications, and mortality among patients. However, data are limited on treatment outcomes and the associated factors among persons with bacteriologically confirmed pulmonary (BC-PTB) in rural areas of high dual tuberculosis and Human Immunodeficiency Virus (HIV) burden countries such as Uganda. We investigated factors associated with successful treatment of tuberculosis and mortality among adult persons with BC-PTB in rural eastern Uganda. Methods: We constructed a retrospective cohort of persons with BC-PTB from a routine tuberculosis clinic database in eastern Uganda. We performed bivariate and multivariate analysis. Using a 5% level of significance, we ran a modified Poisson regression analysis to determine factors independently associated with treatment success and mortality rates. Results: We retrieved 1,123 records for persons with BC-PTB and the treatment outcomes were distributed as follows: 477(42.5%) cured, 323 (28.0%) treatment completed, 17(1.5%) treatment failed, 81(7.2%) died, 89(7.9%) lost to follow-up, and 136(12.1%) not evaluated. Overall, 800 (81.1%) of the 987 persons with BC-PTB that had treatment outcome, were successfully treated. Successful treatment of tuberculosis was less likely to occur among those with HIV infection (Adjusted risk ratio (aRR), 0.88; 95% Confidence Interval (CI), 0.82-0.95), older than 50 years (aRR, 0.89; 95% CI, 0.81-0.97), or male sex (aRR, 0.92; 95% CI, 0.87-0.98). Mortality was associated with HIV infection (aRR, 4.48; 95% CI, 2.95-6.79), older than 50 years (aRR, 2.93; 95% CI, 1.74-4.92), year of enrollment into treatment after 2015 (aRR, 0.80; 95% CI, 0.66-0.97), and Community-Based Directly Observed Therapy Short Course (aRR, 0.26; 95% CI, 0.13-0.50). Conclusions: Treatment success rate among adult persons with BC-PTB in rural eastern Uganda is suboptimal and mortality rate is high. HIV infection and older age reduce chances of treatment success, and increase mortality rate. Older and HIV infected persons with BC-PTB will require special consideration to optimize treatment success rate and reduce mortality rate.

scholarly journals Treatment outcomes and factors associated with “successful treatment” among tuberculosis patients at peripheral health settings of Northern Ethiopia: a registry-based retrospective case-series analysis.

2019 ◽  
Author(s):  
Mahmud Abdulkader ◽  
Ischa van Aken ◽  
Selam Sahle Niguse ◽  
Haftamu Hailekiros ◽  
Mark Spigt
Keyword(s):  
Treatment Outcome ◽  
Success Rate ◽  
Treatment Outcomes ◽  
Successful Treatment ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Northern Ethiopia ◽  
Pulmonary Tb ◽  
Factors Associated ◽  
Objective Evidence

Abstract Objective: Evidence on treatment outcomes and identifying factors facilitating treatment success through a register based retrospective study have significant contribution in the improvement of a national tuberculosis program. This study was aimed at determining treatment outcomes and factors associated with “successful treatment” outcomes. Results: A total of 3445 patient records were included. More than half, (58%) were males and the mean age was 33.88 ± 16.91 years (range: 0-90). From the total TB patients, 18.8% were HIV co infected. The treatment outcome of TB patients were 371 (10.8%) cured, 2234 (64.8) treatment completed, died 119 (3.5%) died, 9 (0.3%) failed, 178 (5.1%) defaulted and 534 (15.5%) were transferred out. The overall treatment success rate was 89.5%. The overall treatment success rate was 87% in year 2009-2010 to 92.8% in 2013-2014 with 6.67% change in the outcome indicator over the five years period. Among pulmonary TB, pulmonary negative TB and extra pulmonary TB the rate of successful treatment outcome was 83.1% to 89%, 85.1% to 89.4%, and 87.4% to 92%, respectively in the year 2009-2010 to 2013-2014. The percentage of the overall successful treatment outcomes were significantly associated with the year of treatment (p- =0.014).

scholarly journals Factors Associated with Successful Trial of Labor after Cesarean Section: A Retrospective Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Aram Thapsamuthdechakorn ◽  
Ratanaporn Sekararithi ◽  
Theera Tongsong
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Success Rate ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Vaginal Birth ◽  
Factors Associated ◽  
Audit System ◽  
Trial Of Labor ◽  
Potential Factor

Objective. To determine the effectiveness of trial of labor after cesarean section (TOLAC) and the factors associated with a successful TOLAC. Materials and Methods. A retrospective cohort study was conducted on consecutive singleton pregnancies with a previous single low-transverse cesarean section planned for TOLAC at a tertiary teaching hospital. The potential risk factors of a successful TOLAC were compared with those associated with a failed TOLAC. A simple audit system used in the first two years was also taken into account in the analysis as a potential factor for success. Results. During the study period, 2,493 women were eligible for TOLAC and 704 of them were scheduled for TOLAC, but finally 592 underwent TOLAC. Among them, 355 (60%) had a successful vaginal birth and 237 (40%) had a failed TOLAC. The independent factors associated with the success rate included the audit system, prior vaginal birth, low maternal BMI, and lower birth weight or gestational age, whereas induction of labor and recurring indications in previous pregnancy significantly increased the risk of having a failed TOLAC. Strikingly, the strongest predictor of a successful TOLAC was the audit system with OR of 6.4 (95%CI: 3.9-10.44), followed by a history of vaginal birth in previous pregnancies (OR: 3.2; 95%CI: 1.87-5.36). Conclusion. The simple audit system had the greatest impact on the success rate of TOLAC, instead of the less powerful obstetrical factors as reported in previous reports. The audit system is the only potential factor that could be strengthened to improve the success rate.

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