Unsuccessful TB treatment outcomes with a focus on HIV co-infected cases: a cross-sectional retrospective record review in a high-burdened province of South Africa

In Pakistan, the treatment of multidrug-resistant tuberculosis (MDR-TB) with a shorter treatment regimen (STR), that is, 4–6 months of amikacin, moxifloxacin (Mfx), ethionamide, clofazimine (Cfz), pyrazinamide (Z), ethambutol (E), and high-dose isoniazid, followed by 5 months of Mfx, Cfz, Z, and E, was initiated in 2018. However, there is a lack of information about its effectiveness in Pakistani healthcare settings. Therefore, this retrospective record review of MDR-TB patients treated with STR at eight treatment sites in Pakistan aimed to fill this gap. Data were analyzed using SPSS 23. Multivariate binary logistic regression (MVBLR) analysis was conducted to find factors associated with death and treatment failure, and lost to follow-up (LTFU). A P-value < 0.05 was considered statistically significant. Of 912 MDR-TB patients enrolled at the study sites, only 313 (34.3%) eligible patients were treated with STR and included in the current study. Of them, a total of 250 (79.9%) were cured, 12 (3.8%) completed treated, 31 (9.9%) died, 16 (5.1%) were LTFU, and four (1.3%) were declared as treatment failures. The overall treatment success rate was 83.7%. In MVBLR analysis, patients’ age of 41–60 (odds ratio [OR] = 4.9, P-value = 0.020) and > 60 years (OR = 3.6, P-value = 0.035), being underweight (OR = 2.7, P-value = 0.042), and previous TB treatment (OR = 0.4, P-value = 0.042) had statistically significant association with death and treatment failure, whereas patients’ age of > 60 years (OR = 5.4, P-value = 0.040) and previous TB treatment (OR = 0.2, P-value = 0.008) had statistically significant association with LTFU. The treatment success rate of STR was encouraging. However, to further improve the treatment outcomes, special attention should be paid to the patients with identified risk factors.

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Integration of TB and ART services fails to improve TB treatment outcomes: Comparison of ART/TB primary healthcare services in Cape Town, South Africa

South African Medical Journal ◽

10.7196/samj.7696 ◽

2014 ◽

Vol 104 (3) ◽

pp. 204 ◽

Cited By ~ 12

Author(s):

R Kaplan ◽

J Caldwell ◽

L-G Bekker ◽

K Jennings ◽

C Lombard ◽

...

Keyword(s):

South Africa ◽

Treatment Outcomes ◽

Primary Healthcare ◽

Cape Town ◽

Healthcare Services ◽

Tb Treatment

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High Levels Of Resistance To First And Second-Line Drugs Among MDR-TB Patients With Favourable Previous TB Treatment Outcomes In South Africa

10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a5309 ◽

2011 ◽

Author(s):

Ronel Odendaal ◽

Joey Lancaster ◽

Charlotte Kvasnovsky ◽

Jeannette Brand ◽

Tracy Dalton ◽

...

Keyword(s):

South Africa ◽

Treatment Outcomes ◽

Second Line ◽

Tb Treatment ◽

Mdr Tb

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ImPROving TB outcomes by modifying LIFE-style behaviours through a brief motivational intervention followed by short text messages (ProLife): study protocol for a randomised controlled trial

10.21203/rs.2.480/v1 ◽

2019 ◽

Author(s):

Andrew Stephen Moriarty ◽

Goedele Maria Louwagie ◽

Noreen Dadirai Md ◽

Neo Marojele ◽

John Tumbo ◽

...

Keyword(s):

South Africa ◽

Smoking Cessation ◽

Randomised Controlled Trial ◽

Alcohol Use ◽

Treatment Outcomes ◽

Life Style ◽

Controlled Trial ◽

Tb Treatment ◽

Secondary Outcomes ◽

Randomised Controlled

Abstract Background South Africa is among the 7 highest tuberculosis (TB) burden countries. Harmful lifestyle behaviours, such as smoking and alcohol, and poor medication adherence can affect clinical outcomes. Modification of these behaviours is likely to improve TB treatment outcomes and has proven possible using motivational interviewing (MI) techniques or use of short message service (SMS) text messaging. There have been no studies assessing the effect of combined MI and SMS interventions on multiple lifestyle factors and TB treatment outcomes. Methods This is a prospective, multi-centre, two-arm individual randomised controlled trial looking at the effectiveness and cost-effectiveness of a complex behavioural intervention (the ProLife programme) on improving TB and lifestyle-related outcomes in 3 provinces of South Africa. The ProLife programme consists of an MI counselling strategy, delivered by lay health workers, augmented with subsequent SMS. We aim to recruit 696 adult participants (aged 18 years and over) with drug-sensitive pulmonary TB who are current smokers and/or report harmful or hazardous alcohol use. Patients will be consecutively enrolled at 27 clinics in 3 different health districts in South Africa. Participants randomised individually to the intervention arm will receive 3 MI counselling sessions 1 month apart. Each MI session will be followed by twice-weekly SMS messages targeting treatment adherence, alcohol use and tobacco smoking, as appropriate. We will assess the effect on TB treatment success, using standard World Health Organization (WHO) treatment outcome definitions (primary outcome), as well as on a range of secondary outcomes including smoking cessation, reduction in alcohol use and TB medication and anti-retroviral therapy adherence. Secondary outcomes will be measured at 3 and 6 months follow-up. Discussion This trial aligns with the WHO agenda of integrating TB care with the care for chronic diseases of life-style, such as provision of smoking cessation treatments, and with the use of digital technologies. If the ProLife programme is found to be effective and cost-effective, the programme could have significant implications for TB treatment globally and could be successfully implemented in a wide range of TB treatment settings.

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Effect of Diabetes Mellitus on Tuberculosis Treatment Outcomes among Tuberculosis Patients in Kelantan, Malaysia

Iranian Journal of Public Health ◽

10.18502/ijph.v49i8.3892 ◽

2020 ◽

Author(s):

Siti Rohana AHMAD ◽

Nor Azwany YAACOB ◽

Mat Zuki JAEB ◽

Zalmizy HUSSIN ◽

Wan Mohd Zahiruddin WAN MOHAMMAD

Keyword(s):

Treatment Outcomes ◽

Multivariable Analysis ◽

Significant Risk ◽

Control Program ◽

Educational Status ◽

Cross Sectional Study ◽

Cross Sectional ◽

Tb Treatment ◽

Unsuccessful Treatment ◽

Using Data

Background: There is growing evidence that DM may play an important role in the occurrence of unsuccessful TB treatment outcomes. This study was undertaken to examine the prevalence of DM among TB population, compare the profile of TB patients with and without DM and determine the effect of DM on unsuccessful treatment outcomes among TB patients in Kelantan state, Malaysia from 2012 to 2016. Methods: A cross sectional study was conducted in Sep 2017 using data from registered TB cases in Kelantan state, Malaysia from 2012 to 2016. The profile of TB patients with and without DM were compared in univariable analysis. Multiple logistic regression was used to determine association between DM and unsuccessful treatment outcomes. Results: A total of 1854 TB patients were diagnosed with DM. The annual proportion was ranging from 26 to 29%. TB patients with DM had an older age, live single, low educational status, poor chest x ray finding and diagnosed with smear positive sputum compared to TB patients without DM. TB patients with DM had three times higher risk to develop unsuccessful TB treatment outcomes compared to TB patients without DM (95% CI 2.47-3.58; P = 0.012) in multivariable analysis. Conclusion: Those with DM had the worst prognosis of TB outcomes among the significant risk factors. TB control program in Malaysia will need to expand efforts to focus on treatment of TB-DM patients to improve their cure rates in order to achieve the goals of tuberculosis elimination.

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