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 Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective 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):  
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

scholarly journals Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective Study in Jos North and Mangu, Plateau State, North – Central Nigeria

2020 ◽  
Author(s):  
Comfort Nanbam Sariem ◽  
Patricia Odumosu ◽  
Maxwell Patrick Dapar ◽  
Jonah Musa ◽  
Luka Ibrahim ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Descriptive Analysis ◽  
Treatment Success ◽  
Infectious Agent ◽  
Success Rates ◽  
North Central ◽  
Tuberculosis Patients ◽  
Tb Treatment ◽  
Plateau State

Abstract Background: Globally, tuberculosis (TB) is the leading cause of death from a single infectious agent. Adherence to TB therapy is an important factor in treatment outcomes, which is a critical indicator for evaluating TB treatment programs. This study assessed TB treatment outcomes using a fifteen-year record of tuberculosis patients who received treatment in Jos North and Mangu Local Government Areas of Plateau State, North-Central Nigeria. Methods: The retrospective facility based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State. Data were collected from 10156 TB patient’s health records between 2001 and 2015. Treatment outcomes were categorized as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). A descriptive analysis was done to assess the factors associated with treatment outcomes. Relevant bivariable and multivariable logistic regression were done. All statistical analyses were performed on Stata version 11, College station, Texas, USA.Results: During the study period, 58.1% (5904/10156) of the TB patients who received treatment were males. The 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. The sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes rate from 83.8% in 2001 to 64.4% in 2015 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. Treatment after loss to follow-up, relapse and treatment failure were less likely associated with treatment success than newly diagnosed TB patients.Conclusion: With the decrease in treatment success rates, underlying reasons for medication non-adherence and treatment failure should be resolved through adherence counseling involving the patient and treatment supporters, with education on voluntary counseling and testing for HIV among TB patients.

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

2020 ◽  
Author(s):  
Comfort Nanbam Sariem ◽  
Patricia Odumosu ◽  
Maxwell Patrick Dapar ◽  
Jonah Musa ◽  
Luka Ibrahim ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Descriptive Analysis ◽  
Treatment Success ◽  
Infectious Agent ◽  
Success Rates ◽  
North Central ◽  
Tuberculosis Patients ◽  
Tb Treatment ◽  
Plateau State

Abstract Background: Globally, tuberculosis (TB) is the leading cause of death from a single infectious agent. Adherence to TB therapy is an important factor in treatment outcomes, which is a critical indicator for evaluating TB treatment programs. This study assessed TB treatment outcomes using a fifteen-year record of tuberculosis patients who received treatment in Jos North and Mangu Local Government Areas of Plateau State Nigeria. Methods: The retrospective facility 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 10156 TB patient’s health records between 2001 and 2015. Treatment outcomes were categorized as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). A descriptive analysis was done to assess the factors associated with treatment outcomes. Relevant bivariable and multivariable logistic regression were done. All statistical analyses were performed on Stata version 11, College station, Texas, USA.Results: During the study period, 58.1% (5904/10156) of the TB patients who received treatment were males. The 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. The sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes rate from 83.8% in 2001 to 64.4% in 2015 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. Treatment after loss to follow-up, relapse and treatment failure were less likely associated with treatment success than newly diagnosed TB patients.Conclusion: With the decrease in treatment success rates, underlying reasons for medication non-adherence and treatment failure should be resolved through adherence counseling involving the patient and treatment supporters, with education on voluntary counseling and testing for HIV among TB patients.

scholarly journals Tuberculosis treatment outcomes: a fifteen-year retrospective study in Jos-North and Mangu, Plateau State, North - Central Nigeria

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Comfort Nanbam Sariem ◽  
Patricia Odumosu ◽  
Maxwell Patrick Dapar ◽  
Jonah Musa ◽  
Luka Ibrahim ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Treatment Outcomes ◽  
Tuberculosis Treatment ◽  
North Central ◽  
Plateau State

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 Epidemiology of tuberculosis and treatment outcomes among children in Pakistan: a 5 year retrospective study

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5253 ◽  
Author(s):  
Madeeha Laghari ◽  
Syed Azhar Syed Sulaiman ◽  
Amer Hayat Khan ◽  
Naheed Memon
Keyword(s):  
Retrospective Study ◽  
Treatment Outcomes ◽  
Urban Areas ◽  
Demographic Data ◽  
Treatment Success ◽  
Clinical Manifestations ◽  
Sputum Smear ◽  
Unsuccessful Treatment ◽  
Patients At Risk ◽  
Group 2

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.

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 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 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.

scholarly journals 565. Tocilizumab Use in COVID-19: Act(emra) to Inhibit Intubation and Decompensation

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S347-S348
Author(s):  
Debra M Willner ◽  
Victoria Bengualid ◽  
Ilanit Zada ◽  
Judith Berger ◽  
Nigam Patel
Keyword(s):  
Treatment Failure ◽  
Sample Size ◽  
Treatment Outcomes ◽  
Inflammatory Markers ◽  
Treatment Success ◽  
Small Sample ◽  
Control Group ◽  
Respiratory Status ◽  
Baseline Characteristics ◽  
Overall Mortality

Abstract Background Tocilizumab is an IL-6 receptor inhibitor that has been utilized for the prevention and treatment of the cytokine storm inflammatory reaction in COVID-19. The objectives of this analysis were to evaluate clinical outcomes of tocilizumab treatment in relation to respiratory status improvements and to analyze the association between initial inflammatory markers and treatment outcomes. Methods IRB approved retrospective chart review of adult patients with confirmed COVID-19 treated with tocilizumab from March- May 2020. Data collection focused on relevant past medical history, hematologic and inflammatory markers before and after tocilizumab administration, concomitant COVID-19 treatments, and disease outcomes such as mortality and discharge. Assessed baseline characteristics and treatment outcomes in patients who received tocilizumab prior to intubation versus after intubation, and evaluated for any significant markers of treatment success and failure. Results 84 patients were evaluated. Baseline characteristics did not vary between intubated and not intubated patients (Figure 1). Overall mortality in patients who received an IL-6 inhibitor was 43%. Mortality in patients who received IL-6 inhibitor when intubated (63%) compared to patients who were not intubated (26%) was significantly higher (p = 0.005). Patients with BMI’s of 30 or above and patients with diabetes had a higher rate of treatment failure (p &lt; 0.05) (Figure 2). Patients with IL-6 levels of 1000 or above had higher rates of treatment failure (p = 0.0001); however, given the small sample size larger studies are required for further analysis (Figure 3). Baseline Characteristics by Respiratory Status Pre-Tocilizumab Administration Subgroup Analysis Outcome by Baseline IL-6 Levels Conclusion Overall mortality in our patients was 43%; however, our sample size was small and the study did not have a control group to fully assess treatment success or failure. Comorbidities such as diabetes and obesity, and elevated IL-6 levels were associated with significantly higher rates of treatment failure. Randomized control trials are needed to determine the true benefit of tocilizumab in COVID-19. Disclosures All Authors: No reported disclosures

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