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

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

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

10.21203/rs.2.11227/v1 ◽

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.

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

10.21203/rs.2.11227/v4 ◽

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.

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

10.21203/rs.2.11227/v3 ◽

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.

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

BMC Public Health ◽

10.1186/s12889-020-09289-x ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 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

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

PeerJ ◽

10.7717/peerj.5253 ◽

2018 ◽

Vol 6 ◽

pp. e5253 ◽

Cited By ~ 4

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.

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Analysis of Tuberculosis Cases Notification and Treatment Outcomes Among Refugee Camps In Kenya: Four Year Retrospective Study, 2014-2017

10.21203/rs.3.rs-116530/v1 ◽

2020 ◽

Author(s):

Tsegay Legesse ◽

Stephen Mulesh ◽

Dorothy Anjuri ◽

Miriam Ngure ◽

Salad Chiari ◽

...

Keyword(s):

Retrospective Study ◽

Treatment Outcomes ◽

Treatment Success ◽

Multiple Logistic Regression Analysis ◽

Refugee Camps ◽

Continuous Increase ◽

Tb Treatment ◽

Unsuccessful Treatment ◽

Childhood Tb

Abstract Background: Tuberculosis (TB) is more severe in refugee populations. Analyzing the key indicators of TB program performance is important to improve the effectiveness of TB control in the refugee camps. This study aimed to analyze trends in TB case notification, treatment outcomes and factors associated with unsuccessful TB treatment in Dadaab and Kakuma refugee camps in Kenya. Methods: In this descriptive retrospective study, demographic and clinical data all TB cases registered in the refugee camps from January 2014 to December 2017 were extracted. Multiple logistic regression analysis was used to estimate odds ratios and 95% confidence intervals for variables associated with unsuccessful TB treatment.Results. A total of 2055 TB cases of whom 56.8% men and 57.7% age 15-44 years were registered. Number of notified cases decreased from 532 in 2014 to 473 in 2016 (11.1% decrease) then increased to 554 in 2017(16.9% increase in one year). From 2014 to 2017 there was consistent increase in percentage of EPTB (16.2% to 21.1%), and in contribution of children (<15 years) to total TB cases (20.3% to 25.8%) and to EPTB (36.1% to 44.4%). Proportion of bacteriologically confirmed new and relapse pulmonary cases increased from 49.5% to 60.9%. Treatment success rate remained higher at 92.6% to 94.4%. On average 41.7% were cured, 2.3% lost to follow-up (LTFU) (increasing from 1.3% to 3.2%), 2.2% died (decreasing from 2.4% to 1.6%), 1.6% not evaluated (decreasing from 3.2% to 1.3%), and 0.5% treatment failed. Unsuccessful treatment outcome was significantly associated with pretreatment weight < 40 Kg, being male, smear positive PTB, HIV infection, and age >15 years (increased with age).Conclusions: Number of notified TB cases has decreased from 2014 to 2016, but increased in 2017. There was continuous increase in percentage of EPTB and childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases has increased overtime. Treatment success remained higher above global target (90%) which should be maintained. Special socioeconomic support and follow-up is required for TB patients who are at higher risk of unsuccessful treatment.

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

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/traa040 ◽

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.

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