Predictors of Adverse TB Treatment Outcome among TB/HIV Patients Compared with Non-HIV Patients in the Greater Accra Regional Hospital from 2008 to 2016

Introduction. The convergence of TB and HIV dual epidemics is a major public health challenge in Ghana as well as many developing countries. Treatment outcome monitoring is a vital part of the surveillance needed to successfully eliminate TB. The impact of HIV status and demographic and treatment-related factors on adverse TB treatment outcome has not been studied in the Greater Accra Regional Hospital. This study determined factors associated with TB treatment outcome in patients with TB-HIV coinfection and TB-only infection in the hospital. Method. A cross-sectional study was carried out in the Greater Accra Regional Hospital. We reviewed TB treatment cards of patients who received treatment for tuberculosis in the hospital from 2008 to 2016. Data on treatment outcome and sociodemographic and clinical characteristics were extracted on TB-only-infected and TB/HIV-coinfected patients. The chi-squared test and binary and multiple logistic regression models were used to assess factors associated with adverse treatment outcome. Results. Out of the 758 patient records analyzed, 174 (22.9%) were TB-HIV-coinfected patients. Overall treatment success for all TB patients was 88.1% (668/758). About 11.9% (90/758) of the patients had an adverse treatment outcome, including treatment failure 0.9% (7/758), defaulting 0.9% (7/758), and death 10.0% (76/758). TB-HIV-coinfected patients’ treatment success was 78.1% (136/174). TB-only patients’ treatment success was 91.4% (532/582). Independent predictors of adverse treatment outcome were found to be as follows: being HIV positive (aOR: 3.85, 95% CI: 2.19-6.75; p<0.01); aged 65 and above (aOR: 1.76, 95% CI: 1.44-1.54; p=0.01); and previously failed TB treatment (aOR: 5.02, 95% CI: 2.09-28.87; p<0.01). Conclusion. Treatment outcome for TB-HIV-coinfected patients is below the WHO target. HIV status, age, and category of patient of the TB patients were associated with adverse treatment outcome. Strengthening the TB/HIV collaborative efforts by stakeholders is required for good treatment outcomes.

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Treatment outcome of tuberculosis at Dilla Referral Hospital, Gedeo Zone, southern Ethiopia: A retrospective study

PLoS ONE ◽

10.1371/journal.pone.0249369 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249369

Author(s):

Endrias Markos Woldesemayat ◽

Zewtir Azeze

Keyword(s):

Risk Factors ◽

Treatment Outcome ◽

Success Rate ◽

Treatment Success ◽

Referral Hospital ◽

Treatment Success Rate ◽

Southern Ethiopia ◽

Hiv Status ◽

Hospital Data ◽

Tb Treatment

Background Tuberculosis (TB) is one of the major public health problems in Ethiopia. Determining treatment outcome of TB cases could help to understand the effectiveness of TB control efforts. The objective of this study was to assess TB treatment outcome and associated factors and determine the risk factors of death among TB cases who were on Directly Observed Treatment Short course (DOTS). Methodology We analyzed a retrospective data for TB cases who were on DOTS at Dilla Referral Hospital from July 2011- June 2016. The study population was TB cases with known HIV status and whose treatment outcome was evaluated at the Hospital. Data were entered, cleaned and analyzed using statistical package SPSS for windows, version 20. Result Out of 899 registered TB cases, 731 included in this analysis. Of these cases, 424 (58.0%) were male and 334 (45.7%) were in the age group of below 25 years. Treatment success rate of TB was 675 (92.3%) and death rate was 18 (2.5%). Treatment outcome showed statistically significant variation by HIV status (P < 0.001). HIV status of the TB cases and pretreatment weight were associated with TB treatment outcome. HIV status of the TB cases was associated with death of the TB cases (Adjusted Odds Ratio (AOR) 5.0; CI 95%: 1.8–13.5). Conclusion TB treatment success rate found in this study was high. Patient’s weight and HIV status were associated with treatment outcome. Moreover, HIV status predicted death of TB cases. Cautious treatment follow-up and defaulter tracing mechanisms for TB cases with these risk factors were suggested.

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INFLUENCE OF PATIENT-RELATED FACTORS ASSOCIATED ON TB OUTCOMES AMONG TB PATIENTS IN MOMBASA COUNTY

Journal of Health, Medicine and Nursing ◽

10.47604/jhmn.1303 ◽

2021 ◽

Vol 6 (3) ◽

pp. 49-65

Author(s):

Godana Barako ◽

Simon Karanja ◽

Rahma Udu

Keyword(s):

Treatment Outcome ◽

Quantitative Data ◽

Psychosocial Support ◽

Work Place ◽

Unique Contribution ◽

Related Factors ◽

Random Sample Size ◽

Factors Associated ◽

Tb Treatment ◽

Treatment Implementation

Purpose: The purpose of the study was to determine patient-related factors associated with TB outcomes among TB patients in Mombasa County. Methodology: Study was conducted in Mombasa County which is one of the 47 counties in Kenya with an urban population of 1,063,854. The study used a cross-sectional research design. The study population was the total number of notified patients with tuberculosis in one quarter in the study area (Mombasa’s health care units) and this was found to be 1207 in the year 2017. It was from this population that a systematic random sample size of 292 patients were interviewed. Quantitative data were analyzed using SPSS version 20 Descriptive statistics frequency (%), mean, and standard deviation were used to express quantitative data. In bivariate analyses, odds ratios (OR) and 95% confidence intervals (CI) for the association between TB treatment outcome and health related factors, institutional factors and patient related factors was done using logistic regression. Results: The results revealed that patients who are educated about health are more likely to cure of TB than patients who are not (OR 1.716, 95% CI, 0.35 to 1.48). More so, patients who receive psychosocial support are more likely to get cured than those who don’t receive psychosocial support (OR 4.08, 95% CI, 2.00 to 8.32). The results of the study give evidence to, therefore, conclude patient related factors are critical to TB treatment outcome. Unique contribution to theory, policy and practice: Strengthening TB adherence counselling for patients treated for the first time to improve treatment completion. Counselling service should also be enhanced for patients taking alcohol and those smoking cigarettes as both are associated with less likelihood of completing TB treatment. Implementation of TB work place program through sensitization of company managers on the importance of TB treatment support to reduce chances of loss to follow as sighted by focused group discussions. Patients centred TB services should be provided by all facilities by focusing on the needs of the patients by agreeing on the best time to pick drugs to reduce the risk of loss to follow ups.

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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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1206 ◽

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.

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Treatment success for patients with tuberculosis receiving care in areas severely affected by Hurricane Matthew – Haiti, 2016

PLoS ONE ◽

10.1371/journal.pone.0247750 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0247750

Author(s):

Macarthur Charles ◽

Milo Richard ◽

Mary R. Reichler ◽

Jean Baptiste Koama ◽

Willy Morose ◽

...

Keyword(s):

Treatment Success ◽

Lessons Learned ◽

Health Facilities ◽

Hiv Status ◽

Severe Damage ◽

Convenience Sample ◽

Tb Control ◽

Tb Treatment ◽

One Year ◽

The Impact

Background On October 4, 2016, Hurricane Matthew struck southwest Haiti as a category 4 storm. The goal of this study was to evaluate the impact of the hurricane on tuberculosis (TB) services and patient outcomes in the three severely affected departments–Sud, Grand’Anse, and Nippes–of southwest Haiti. Methods We developed a standard questionnaire to assess a convenience sample of health facilities in the affected areas, a patient tracking form, and a line list for tracking all patients with drug-susceptible TB registered in care six months before the hurricane. We analyzed data from the national TB electronic surveillance system to determine outcomes for all patients receiving anti-TB treatment in the affected areas. We used logistic regression analysis to determine factors associated with treatment success. Results Of the 66 health facilities in the three affected departments, we assessed 31, accounting for 536 (45.7%) of 1,174 TB patients registered in care when Hurricane Matthew made landfall in Haiti. Three (9.7%) health facilities sustained moderate to severe damage, whereas 18 (58.1%) were closed for <1 week, and five (16.1%) for ≥1 week. Four weeks after the hurricane, 398 (73.1%) of the 536 patients in the assessed facilities were located. Treatment success in the affected departments one year after the hurricane was 81.4%. Receiving care outside the municipality of residence (adjusted odds ratio [aOR]: 0.46, 95% confidence interval [CI]: 0.27–0.80) and HIV positivity (aOR: 0.31, 95% CI: 0.19–0.51) or unknown HIV status (aOR: 0.49, 95% CI: 0.33–0.74) were associated with significantly lower rates of treatment success. Conclusions Despite major challenges, a high percentage of patients receiving anti-TB treatment before the hurricane were located and successfully treated in southwest Haiti. The lessons learned and results presented here may help inform policies and guidelines in similar settings for effective TB control after a natural disaster.

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Treatment outcome monitoring of pulmonary tuberculosis cases notified in France in 2009

Eurosurveillance ◽

10.2807/ese.18.12.20434-en ◽

2013 ◽

Vol 18 (12) ◽

Author(s):

D Antoine ◽

D Che

Keyword(s):

Treatment Outcome ◽

Treatment Success ◽

Previous History ◽

The Elderly ◽

Successful Outcome ◽

Unfavourable Outcome ◽

Tb Control ◽

Tb Treatment ◽

Outcome Monitoring ◽

National Tuberculosis

The proportion of patients considered to be cured is a key indicator to assess national tuberculosis (TB) control. In France, TB treatment outcome monitoring was implemented in 2007. This article presents national results on treatment outcome among patients with pulmonary TB reported in France in 2009 and explores determinants of potentially unfavourable outcome. Information on treatment outcome was reported for 63% of eligible pulmonary cases of whom 70% had a successful outcome. In a multivariate analysis, potentially unfavourable outcome (17%), compared to treatment success, was significantly associated with being male, born abroad and having lived in France for less than 10 years, being in congregate settings when treatment was initiated, or having a previous history of anti-TB treatment. Enhanced awareness of treatment outcome monitoring is essential to improve the coverage and the quality of information. Earlier diagnosis and improved management of the disease in the elderly may reduce death due to TB. The high proportion of potentially unfavourable outcomes should be further investigated as they may require additional vigilance and/or actions in term of efforts of TB control in some population groups.

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Predictors for Pulmonary Tuberculosis Treatment Outcome in Denmark 2009–2014

Scientific Reports ◽

10.1038/s41598-019-49439-9 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Inge K. Holden ◽

Troels Lillebaek ◽

Niels Seersholm ◽

Peter H. Andersen ◽

Christian Wejse ◽

...

Keyword(s):

Risk Factors ◽

Treatment Outcome ◽

Treatment Success ◽

Control Program ◽

Success Rates ◽

Unfavourable Outcome ◽

Pulmonary Tb ◽

Factors Associated ◽

Tb Treatment ◽

Low Incidence

Abstract Monitoring of tuberculosis (TB) treatment outcome is essential to ensure an effective TB control program. In this nationwide retrospective cohort study from Denmark we present TB treatment outcome rates and risk factors associated with an unfavourable outcome. All patients notified with pulmonary TB from 2009 through 2014 were included. Logistic regression analyses were used to identify risk factors for unfavourable outcome. In total, 1681 pulmonary TB cases were included. TB treatment success rates increased during the study period. In 2014, the treatment success rate reached 85% for new culture positive cases whereas 7% cases interrupted treatment. The mortality decreased during the study period from 12.3% to 4.1%. Several risk factors associated with unfavourable outcome were identified in a multivariable model: male (OR: 2.56), Greenlandic origin (OR: 1.80), abuse of alcohol (OR: 2.90), history of mental disorder (OR: 2.46), and anaemia at time of treatment initiation (OR: 1.92). In a TB low incidence setting such as the Danish, it is important to maintain focus on preventing an unfavourable TB outcome. Patient management and treatment can be optimized by taking into consideration risk factors such as those identified in the present study.

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Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014

Eurosurveillance ◽

10.2807/1560-7917.es.2019.24.12.1800392 ◽

2019 ◽

Vol 24 (12) ◽

Cited By ~ 4

Author(s):

Basel Karo ◽

Anke Kohlenberg ◽

Vahur Hollo ◽

Raquel Duarte ◽

Lena Fiebig ◽

...

Keyword(s):

Risk Factors ◽

Treatment Outcome ◽

Treatment Success ◽

Absolute Difference ◽

Outcome Analysis ◽

Smear Microscopy ◽

European Economic Area ◽

Tb Treatment ◽

Unsuccessful Treatment ◽

The Impact

Introduction: Isoniazid (INH) is an essential drug for tuberculosis (TB) treatment. Resistance to INH may increase the likelihood of negative treatment outcome. Aim: We aimed to determine the impact of INH mono-resistance on TB treatment outcome in the European Union/European Economic Area and to identify risk factors for unsuccessful outcome in cases with INH mono-resistant TB. Methods: In this observational study, we retrospectively analysed TB cases that were diagnosed in 2002–14 and included in the European Surveillance System (TESSy). Multilevel logistic regression models were applied to identify risk factors and correct for clustering of cases within countries. Results: A total of 187,370 susceptible and 7,578 INH mono-resistant TB cases from 24 countries were included in the outcome analysis. Treatment was successful in 74.0% of INH mono-resistant and 77.4% of susceptible TB cases. In the final model, treatment success was lower among INH mono-resistant cases (Odds ratio (OR): 0.7; 95% confidence interval (CI): 0.6–0.9; adjusted absolute difference in treatment success: 5.3%). Among INH mono-resistant TB cases, unsuccessful treatment outcome was associated with age above median (OR: 1.3; 95% CI: 1.2–1.5), male sex (OR: 1.3; 95% CI: 1.1–1.4), positive smear microscopy (OR: 1.3; 95% CI: 1.1–1.4), positive HIV status (OR: 3.3; 95% CI: 1.6–6.5) and a prior TB history (OR: 1.8; 95% CI: 1.5–2.2). Conclusions: This study provides evidence for an association between INH mono-resistance and a lower likelihood of TB treatment success. Increased attention should be paid to timely detection and management of INH mono-resistant TB.

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Tuberculosis treatment outcomes of notified cases: trends and determinants of potential unfavourable outcome, France, 2008 to 2014

Eurosurveillance ◽

10.2807/1560-7917.es.2020.25.4.1900191 ◽

2020 ◽

Vol 25 (4) ◽

Cited By ~ 1

Author(s):

Jean-Paul Guthmann ◽

Lucie Léon ◽

Delphine Antoine ◽

Daniel Lévy-Bruhl

Keyword(s):

Treatment Outcome ◽

Error Variance ◽

Multidrug Resistant ◽

Surveillance Data ◽

Unfavourable Outcome ◽

Factors Associated ◽

Tb Treatment ◽

Outcome Monitoring ◽

Over Time

Background Surveillance of tuberculosis (TB) treatment outcome, for which reporting has been mandatory in France since 2007, is a key component of TB control. Aim We aimed to present surveillance data for non-multidrug-resistant (MDR) cases reported between 2008 and 2014, and identify factors associated with potentially unfavourable treatment outcome. Methods Patients were classified according to their treatment outcome 12 months after beginning treatment. Poisson regression with a robust error variance was used to investigate factors associated with potentially unfavourable treatment outcome. Missing data were handled using multiple imputation. Results A total of 22,526 cases were analysed for treatment outcome. Information available on treatment outcome increased between 2008 (60%) and 2014 (71%) (p < 0.001). During this period, 74.1% of cases completed treatment, increasing from 73.0% in 2008 to 76.9% in 2014 (p < 0.001). This proportion was 74.0% in culture-positive pulmonary cases. Overall, 19.8% of cases had a potentially unfavourable outcome, including lost-to-follow-up, transferred out, still on treatment, death related to TB and interrupted treatment. Potentially unfavourable outcome was significantly associated with TB severity, residing in congregate settings, homelessness, being a smear-positive pulmonary case, being born abroad and residing in France for < 2 years, history of previous anti-TB treatment and age > 85 years. Conclusion Monitoring of treatment outcome is improving over time. The increase in treatment completion over time suggests improved case management. However, treatment outcome monitoring needs to be strengthened in cases belonging to population groups where the percentage of unfavourable outcome is the highest and in cases where surveillance data shows poorer documented follow-up.

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Prevalence and family factors associated with loneliness during COVID-19: A cross-sectional study from South India

INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES ◽

10.32746/10.32746/ijmhns.2020.v3.i2.52 ◽

2020 ◽

Vol 3 (02) ◽

pp. 61-67

Author(s):

G. Sanjana ◽

Vijaya Raghavan

Keyword(s):

Online Survey ◽

South India ◽

Survey Design ◽

Southern India ◽

Related Factors ◽

Cross Sectional ◽

Health Crisis ◽

Factors Associated ◽

Family Discord ◽

The Impact

Background: Loneliness can affect anyone at any point in their life. It can be detrimental to the wellbeing and quality of life of individuals and communities. In the ongoing COVID-19 pandemic, loneliness is considered as a public health crisis. Hence, the objectives of the study were to estimate the prevalence of loneliness and family related factors associated with loneliness among general population in south India. Materials and Methods: The study employed a crosssectional online survey design. The data was collected in the first phase of the lockdown in 2020 from adults in Southern India. Socio-demographic profile and family related variables were collected using a semistructured proforma. Loneliness was assessed by UCLA loneliness scale. Results: Of 573 total respondents to the survey, aged between 18-65 years, 43% were male and 57% were female. The overall prevalence of loneliness was 63% (358/573). No significant gender differences were observed in the prevalence of loneliness. Family discord was associated with higher rates of loneliness (p less than 0.01). Other factors associated were younger age and being single. Conclusion: Rates of loneliness during the COVID-19 lockdown were high in Southern India. Findings suggest that interventions should prioritize younger people. Increasing social support and improving interpersonal skills, which in turn would help reduce family discord and may reduce the impact of COVID-19 on loneliness.

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Factors Associated with Unsuccessful Treatment of Tuberculosis in Arsi-Robe Hospital, Arsi Zone, Ethiopia: A Retrospective Study

10.21203/rs.3.rs-151177/v1 ◽

2021 ◽

Author(s):

Addisu Assefa ◽

Ararsa Girma ◽

Helmut Kloos

Keyword(s):

Treatment Outcome ◽

Retrospective Study ◽

Rural Areas ◽

Urban Areas ◽

Treatment Success ◽

Hiv Positive ◽

Multivariable Logistic Regression Analysis ◽

Eastern Ethiopia ◽

Factors Associated ◽

Unsuccessful Treatment

Abstract Background: Tuberculosis remains a major global health problem and ranks along with the human immunodeficiency virus (HIV) as a leading cause of mortality worldwide. The aim of this study was to investigate the treatment outcome of tuberculosis, and factors associated with treatment outcome of tuberculosis in TB patients enrolled in Arsi-Robe Hospital, Oromia regional state, South eastern Ethiopia between January 2013 to December 2017. Methods: An Institutional-based retrospective study was conducted in Arsi-Robe Hospital from 2013 to 2017 in study patients who had all forms of TB in DOTS clinic. The predictors of treatment outcomes were analyzed through bivariate and multivariable logistic regression analysis and a P-value < 0.05 were considered statistically significant. Results: Out of the 257 registered TB patients, most of them were males (57.9%), from rural areas (62.6%) and in age of 15-24 category (39.3%). PTB-, PTB+ and EPTB were recorded in 48.2%, 32% and 19.8% of the patients, respectively. Among all cases, 8.6% had TB-HIV co-infection. Among all TB cases, 84.0% had successful treatment outcome. TB patients from urban areas (AOR: 3.34, 95% CI: 1.338.38, P = 0.01), with failure treatment (AOR: 6.66, 95% CI = 1.12- 39.57; P = 0.037) and HIV positive (AOR: 4.92, 95% CI = 1.38-17.51; P = 0.014) had higher odd of unsuccessful treatment outcome of tuberculosis. However, TB patients with PTB+ (AOR: 0.1470, 95% CI = 0.031-0.687; P = 0.015) and EPTB (AOR: 0.194, 95% CI = 0.054-0.688; P = 0.011) had significantly lesser odd of unsuccessful treatment outcome. Conclusions: Being urban resident, treatment failure and HIV positive considerably challenge the treatment outcome of tuberculosis, but being PTB+ and EPTB were associated with higher treatment success rate of TB. Continuous follow-up of patients with unsuccessful treatment outcome of tuberculosis with strengthened implementation of the DOTs strategies are suggested. Trial Registered: retrospectively registered

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