scholarly journals The Effect of Incarceration on Tuberculosis Treatment Outcomes in Brazil: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Jamieson M. O'Marr ◽  
Crhistinne Goncalves ◽  
Denise Arakaki-Sanchez ◽  
Daniele Maria Pelissari ◽  
Fernanda Dockhorn Costa ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Latin American ◽  
Treatment Success ◽  
Tuberculosis Treatment ◽  
Directly Observed Therapy ◽  
Multivariate Logistic Regression ◽  
Factors Associated ◽  
The Past ◽  
Incarcerated Population ◽  
Poor Outcomes

Background: Tuberculosis notifications in Latin American prisons have more than doubled over the past two decades; however, treatment outcomes and their determinants among incarcerated individuals in this region are not well understood. Methods: Newly diagnosed drug-susceptible tuberculosis cases reported to Brazils Sistema de Informação de Agravos de Notificação (SINAN) between January 2015 and December 2017 were included. Multivariate logistic regression was used to assess socioeconomic and clinical factors associated with treatment success among incarcerated individuals. Results: Incarcerated individuals (n=17,776) had greater treatment success than non-incarcerated individuals (n=160,728; 82.2% vs 75.1%, p<0.0001), including after adjusting for demographic and clinical risk factors (adjusted Odds Ratio [aOR]: 1.27; 95% CI: 1.19-1.34). These differences were partially mediated by increased use of directly observed therapy among incarcerated individuals (DOT) (61% vs 47%, p<0.001), which was associated with greater efficacy in the incarcerated population (aOR 2.56 vs aOR 2.17; p<0.001). DOT was associated with improved treatment success among incarcerated subpopulations at elevated risk of poor outcomes. Conclusion: Tuberculosis treatment success among incarcerated individuals in Brazil is higher than non-incarcerated individuals, but both fall below WHO targets. Expanding the use of DOT and services for socially and medically vulnerable individuals may improve outcomes in carceral settings.

scholarly journals Factors associated with treatment failure, dropout, and death in a cohort of tuberculosis patients in Recife, Pernambuco State, Brazil

2007 ◽  
Vol 23 (7) ◽  
pp. 1573-1582 ◽  
Author(s):  
Maria de Fátima Pessoa Militão de Albuquerque ◽  
Ricardo Arraes de Alencar Ximenes ◽  
Norma Lucena-Silva ◽  
Wayner Vieira de Souza ◽  
Andréa Tavares Dantas ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Group Treatment ◽  
Healthcare Access ◽  
Treatment Delay ◽  
Tuberculosis Treatment ◽  
Directly Observed Therapy ◽  
Factors Associated ◽  
Family Health Program ◽  
Tb Treatment

A cohort of cases initiating tuberculosis treatment from May 2001 to July 2003 was followed in Recife, Pernambuco State, Brazil, to investigate biological, clinical, social, lifestyle, and healthcare access factors associated with three negative tuberculosis treatment outcomes (treatment failure, dropout, and death) separately and as a group. Treatment failure was associated with treatment delay, illiteracy, and alcohol consumption. Factors associated with dropout were age, prior TB treatment, and illiteracy. Death was associated with age, treatment delay, HIV co-infection, and head of family's income. Main factors associated with negative treatment outcomes as a whole were age, HIV co-infection, illiteracy, alcoholism, and prior TB treatment. We suggest the following strategies to increase cure rates: further training of the Family Health Program personnel in TB control, awareness-raising on the need to tailor their activities to special care for cases (e.g., literacy training); targeting use of directly observed therapy for higher risk groups; establishment of a flexible referral scheme to handle technical and psychosocial problems, including alcoholism; and increased collaboration with the HIV/AIDS program.

Treatment outcomes among multidrug-resistant TB patients in Bahawal Victoria Hospital, Bahawalpur, Pakistan: a retrospective record review

2020 ◽  
Vol 114 (10) ◽  
pp. 733-741
Author(s):  
Muhammad Atif ◽  
Wajiha Ahmad ◽  
Nafees Ahmad ◽  
Iram Malik ◽  
Sajjad Sarwar
Keyword(s):  
Success Rate ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
Binary Logistic Regression ◽  
Multidrug Resistant ◽  
Treatment Success Rate ◽  
Binary Logistic Regression Analysis ◽  
Factors Associated ◽  
Unsuccessful Treatment ◽  
Mdr Tb

Abstract Background This study aims to evaluate the treatment outcomes and factors associated with unsuccessful treatment outcomes among multidrug-resistant TB (MDR-TB) patients. Method This was a retrospective observational study conducted at the Bahawal Victoria Hospital, Bahawalpur, Pakistan. The sociodemographic, clinical and treatment-related data of MDR-TB patients registered at the study site between June 2014 and December 2016 were retrospectively collected. Patients’ treatment outcomes were categorized on the basis of WHO-recommended criteria. Multivariate binary logistic regression analysis was used to find the independent factors associated with unsuccessful treatment outcomes. Results Out of 179 MDR-TB patients, 106 (59.2%) completed their treatment successfully. The remaining 73 patients (40.8%) had unsuccessful treatment outcomes, among whom 45 (25.1%) died, while 18 (10.1%) were lost to follow-up. Factors associated with unsuccessful treatment outcomes included age ≥40 y (AOR 4.310; p = 0.006), unsuccessful interim treatment outcomes (AOR 5.810; p = 0.032), occurrence of adverse events (AOR 0.290; p = 0.029) and ofloxacin resistance (AOR 2.952; p = 0.042). Conclusion The treatment success rate among the selected cohort of MDR-TB patients was less than the target of ≥75% set by the WHO in the End TB Strategy. The lower treatment success rate at the study site requires urgent attention from clinicians and program managers.

scholarly journals Treatment Outcomes and Associated Factors in Tuberculosis Patients at Atwima Nwabiagya District, Ashanti Region, Ghana: A Ten-Year Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Sadick Ahmed Agyare ◽  
Francis Adjei Osei ◽  
Samuel Frimpong Odoom ◽  
Nicholas Karikari Mensah ◽  
Ernest Amanor ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Success Rate ◽  
Treatment Outcomes ◽  
Successful Treatment ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Directly Observed Therapy ◽  
Active Monitoring ◽  
Successful Treatment Outcome ◽  
Unsuccessful Treatment

Introduction. Tuberculosis poses a great threat to public health around the globe and affects persons mostly in their productive age, notwithstanding; everyone is susceptible to tuberculosis (TB) infection. To assess the effectiveness and performance of the tuberculosis control program activities, the percentage of cases with treatment success outcome is key. To control tuberculosis, interrupting transmission through effective treatment cannot be overemphasized. The study was conducted to determine factors associated with TB treatment outcome, in the Atwima Nwabiagya District from 2007–2017. Method. A Retrospective review of routine/standard TB registers was carried out in five directly observed therapy short-course (DOTS) centres at the Atwima Nwabiagya District from January 2007 to December 2017. Demographic characteristics, clinical characteristics, and treatment outcomes were assessed. Bivariate and multivariate logistic regression was conducted to determine the predictors of successful treatment outcome. Results. Of the 891 TB client’s data that was assessed in the district, the treatment success rate was 68.46%. Patients, aged ≤ 20 years (adjusted odds ratio aOR = 4.74 , 95 % CI = 1.75 − 12.83 ) and 51-60 years ( aOR = 1.94 , 95 % CI = 1.12 − 3.39 ), having a pretreatment weight of 35-45 kg ( aOR = 2.54 , 95 % CI = 1.32 − 4.87 ), 46-55 kg ( aOR = 2.75 , 95 % CI = 1.44 − 5.27 ) and 56-65 kg ( aOR = 3.04 , 95 % CI = 1.50 − 6.14 ) were associated with treatment success. However, retreatment patients ( aOR = 0.31 , 95 % CI = 0.11 − 0.84 ) resulted in unsuccessful treatment outcome. Conclusion. Successful treatment outcome among TB patients was about 20.00% and 30.00% lower compared to the national average treatment success rate and WHO target, respectively. Active monitoring, motivation, and counselling of retreatment patients and patients with advanced age are key to treatment success.

scholarly journals TUBERCULOSIS TREATMENT OUTCOMES: A FIFTEEN YEAR COHORT STUDY IN JOS NORTH AND MANGU, PLATEAU STATE, NORTH - CENTRAL NIGERIA

2019 ◽  
Author(s):  
Comfort Nanbam Sariem ◽  
Patricia Odumosu ◽  
Maxwell Patrick Dapar ◽  
Jonah Musa ◽  
Luka Ibrahim ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Treatment Failure ◽  
Treatment Outcomes ◽  
Cause Of Death ◽  
Treatment Success ◽  
Tuberculosis Treatment ◽  
Patient Treatment ◽  
North Central ◽  
Unsuccessful Treatment ◽  
Plateau State

Abstract Background Tuberculosis (TB) is an infectious disease with a major global health problem; being the tenth leading cause of death worldwide, and the leading cause of death from a single infectious agent. Nigeria is among the countries with high burden of tuberculosis and the highest global mortality rate. Medication adherence has been shown to have profound effect on other treatment outcomes. Objective To examine a fifteen-year cohort of tuberculosis treatment outcomes in Jos North and Mangu Local Government Areas of Plateau State. Methods The study was done in five treatment centers which account for more than half of data for tuberculosis patients in Plateau State, North-Central Nigeria. The retrospective study was done from 2001 to 2015, where TB patient records who had completed treatment were evaluated. Treatment outcomes were classified as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death) and analyzed using binomial logistic regression. Results Males composed 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. The Predictors of medication non-adherence were patients with unknown HIV status (OR 4.29, 95% CI: 3.74-4.91, p < 0.001); being male (OR 1.15, CI: 1.37-1.66, p = 0.008) and having a history of non-adherence (OR 2.27, CI: 1.34-3.87, p = 0.002) and treatment failure (OR 2.83, CI: 0.98 – 8.19, p = 0.05). Conclusion Underlying reasons for medication non-adherence and treatment failure identified should be resolved by the patient, treatment supporter and health worker. Increased awareness and education on voluntary counseling and testing of HIV among TB patients is advocated, particularly among the male population.

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 Prevalence and Factors Associated with Tuberculosis Treatment Success among TB/ HIV Co-Infection in North-East Malaysia

2017 ◽  
Vol 24 (6) ◽  
pp. 75-82 ◽  
Author(s):  
Tengku Mardhiah Tengku Jalal ◽  
◽  
Sarimah Abdullah ◽  
Farhanah Abd Wahab ◽  
Sharina Dir ◽  
...  
Keyword(s):  
Treatment Success ◽  
Tuberculosis Treatment ◽  
Factors Associated ◽  
North East ◽  
East Malaysia

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 ◽  
Treatment Outcomes ◽  
Successful Treatment ◽  
Treatment Success ◽  
Case Series ◽  
Northern Ethiopia ◽  
Multinomial Regression ◽  
Retrospective Case ◽  
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. However there is a scarcity of data from peripheral health settings in Ethiopia. Therefore this study was aimed at determining treatment outcomes and factors associated with “successful treatment” outcomes among tuberculosis patients.Results A total of 3445 patient records were included. More than half, (58%) were males and the mean age was 33.88 ± 16.91 (range: 0-90). Majority, 1471 (42.7%) had extra-pulmonary TB. From the total TB patients, 18.8% were HIV co infected. The overall treatment success rate was 89.5%. 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. A successful treatment outcome was achieved in 2605 (89.3%). Multinomial regression analysis revealed that being new treatment case (AOR 1.76; 95% CI: 1.19 to 2.60, p=0.005) and age less than 17 years old (AOR 1.65; 95% CI: 1.01 to 2.68, p=0.045) to be statistically associated with favorable treatment outcome.

scholarly journals Risk Factors Associated with Outcomes of Recombinant Tissue Plasminogen Activator Therapy in Patients with Acute Ischemic Stroke

2020 ◽  
Vol 17 (2) ◽  
pp. 618 ◽  
Author(s):  
Yi-Ju Tseng ◽  
Ru-Fang Hu ◽  
Shin-Tyng Lee ◽  
Yu-Li Lin ◽  
Chien-Lung Hsu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Treatment Outcomes ◽  
Plasminogen Activator ◽  
Tissue Type ◽  
Hospital Death ◽  
Factors Associated ◽  
Laboratory Test Results ◽  
Poor Outcomes

Ischemic stroke is the most common type of stroke, and early interventional treatment is associated with favorable outcomes. In the guidelines, thrombolytic therapy using recombinant tissue-type plasminogen activator (rt-PA) is recommended for eligible patients with acute ischemic stroke. However, the risk of hemorrhagic complications limits the use of rt-PA, and the risk factors for poor treatment outcomes need to be identified. To identify the risk factors associated with in-hospital poor outcomes in patients treated with rt-PA, we analyzed the electronic medical records of patients who were diagnosed with acute ischemic stroke and treated for rt-PA at Chang Gung Memorial Hospitals from 2006 to 2016. In-hospital death, intensive care unit (ICU) stay, or prolonged hospitalization were defined as unfavorable treatment outcomes. Medical history variables and laboratory test results were considered variables of interest to determine risk factors. Among 643 eligible patients, 537 (83.5%) and 106 (16.5%) patients had favorable and poor outcomes, respectively. In the multivariable analysis, risk factors associated with poor outcomes were female gender, higher stroke severity index (SSI), higher serum glucose levels, lower mean corpuscular hemoglobin concentration (MCHC), lower platelet counts, and anemia. The risk factors found in this research could help us study the treatment strategy for ischemic stroke.

scholarly journals Adverse treatment outcomes in multidrug resistant tuberculosis go beyond the microbe-drug interaction: Results of a multiple correspondence analysis.

Biomédica ◽  
2020 ◽  
Vol 40 (4) ◽  
pp. 616-625
Author(s):  
Ángela Tobón ◽  
Johana Rueda ◽  
Diego H. Cáceres ◽  
Gloria I. Mejía ◽  
Elsa M. Zapata ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Treatment Success ◽  
Multidrug Resistant ◽  
Chronic Obstructive ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Poor Outcomes ◽  
Lost To Follow Up

Introduction: Multidrug-resistant tuberculosis treatment is effective in 50% of patients due to several factors including antibiotic susceptibility of the microorganism, adverse treatment reactions, social factors, and associated comorbidities.Objectives: In this study, we describe the demographics, clinical characteristics, and factors associated with treatment outcomes in multidrug-resistant tuberculosis (MDR-TB) patients in Medellín, Colombia.Materials and methods: We conducted a retrospective analysis using data from patients diagnosed with MDR-TB attending Hospital La María in Medellín, Colombia, for treatment between 2010 and 2015. Patients were categorized as having successful (cured) or poor (failure, lost to follow-up, and death) treatment outcomes. Associations between demographic, clinical factors, laboratory results, treatment outcomes, and follow-up information were evaluated by univariate, multivariate, and multiple correspondence analyses.Results: Of the 128 patients with MDR-TB, 77 (60%) had successful outcomes. Of those with poor outcomes, 26 were lost to follow-up, 15 died, and 10 were treatment failures. Irregular treatment, the presence of comorbidities, and positive cultures after more than two months of treatment were associated with poor outcomes compared to successful ones (p<0.05 for all). The multiple correspondence analyses grouped patients who were lost to follow-up, had HIV, and drug addiction, as well as patients with treatment failure, irregular treatment, and chronic obstructive pulmonary disease.Conclusion: The recognition of factors affecting treatment is essential and was associated with treatment outcomes in this series of patients. Early identification of these factors should increase the rates of treatment success and contribute to MDR-TB control.

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