scholarly journals Intensive Phase Treatment Outcome and Associated Factors among Patients Treated for Multi Drug Resistant Tuberculosis in Ethiopia: A retrospective cohort study

2019 ◽  
Author(s):  
Teklu Molie ◽  
Zelalem Teklemariam ◽  
Eveline Klinkenberg ◽  
Yadeta Dessie ◽  
Andargachew Kumsa ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Retrospective Cohort ◽  
Multinomial Logistic Regression ◽  
Treatment Success ◽  
Drug Resistant ◽  
Contributing Factors ◽  
Drug Resistant Tuberculosis ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis

Abstract Background Multi-drug resistant Tuberculosis (MDRTB) is a strain of Mycobacterium tuberculosis that is resistant to at least Rifampicin and Isoniazid drugs. The treatment success rate for MDRTB cases is lower than for drug susceptible TB. Monitoring the early treatment outcome and better understanding the specific reasons for early unfavorable treatment outcome are important to evaluate the effectiveness of tuberculosis control and preventing the emergence of extremely drug resistant tuberculosis. However, this information is scarce in Ethiopia. Therefore, this study aimed to determine the intensive phase treatment outcome and factors contributing among patients treated for MDRTB in Ethiopia. Methods A 6 year (2009 to 2014) retrospective cohort record review was conducted in fourteen treatment initiating centers in Ethiopia. The records of 751 MDRTB patients were randomly selected using simple random sampling. Data were collected using a pre-tested and structured checklist. Multivariable multinomial logistic regression model was undertaken to identify the contributing factors. Results At the end of the intensive phase, 17.3% of MDRTB patients had an unfavorable treatment outcome while 16.8% had an unknown outcome with the rest having a favorable outcome. The median duration of the intensive phase was 9.0 months (IQR 8.04-10.54). Having an unfavorable intensive phase treatment outcome was found to be more common among older aged [ARRR= 1.047, 95% CI (1.024, 1.072)] and those without a history of hypokalemia [ARRR=0.512, 95% CI (0.280, 0.939)]. Having an unknown intensive phase treatment outcome was found to be more common among those treated under the ambulatory care model [ARRR=3.2, 95% CI (1.6, 6.2)], rural dwellers [ARRR= 0.370, 95% CI (0.199, 0.66)], those without a treatment supporter [ARRR=0.022, 95% CI (0.002, 0.231)], and those with resistance to a limited number of drugs. Conclusion We observed a higher than anticipated rate of unfavorable and unknown treatment outcomes in this study. To improve favorable treatment outcome more emphasis should be given to conducting all scheduled laboratory monitoring tests, assignment of trained treatment supporters and ensuring complete recording and reporting which could be enhanced by quarterly cohort review. Older aged and rural patients need special attention. Furthermore, the sample referral network should be strengthened.

scholarly journals Intensive Phase Treatment Outcome and Associated Factors among Patients Treated for Multi Drug Resistant Tuberculosis in Ethiopia: A retrospective cohort study

2019 ◽  
Author(s):  
Teklu Molie ◽  
Zelalem Teklemariam ◽  
Eveline Klinkenberg ◽  
Yadeta Dessie ◽  
Andargachew Kumsa ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Retrospective Cohort ◽  
Multinomial Logistic Regression ◽  
Treatment Success ◽  
Drug Resistant ◽  
Contributing Factors ◽  
Drug Resistant Tuberculosis ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis

Abstract Background Multi-drug resistant Tuberculosis (MDRTB) is a strain of Mycobacterium tuberculosis that is resistant to at least Rifampicin and Isoniazid drugs. The treatment success rate for MDRTB cases is lower than for drug susceptible TB. Monitoring the early treatment outcome and better understanding the specific reasons for early unfavorable treatment outcome are important to evaluate the effectiveness of tuberculosis control and preventing the emergence of extremely drug resistant tuberculosis. However, this information is scarce in Ethiopia. Therefore, this study aimed to determine the intensive phase treatment outcome and factors contributing among patients treated for MDRTB in Ethiopia. Methods A 6 year (2009 to 2014) retrospective cohort record review was conducted in fourteen treatment initiating centers in Ethiopia. The records of 751 MDRTB patients were randomly selected using simple random sampling. Data were collected using a pre-tested and structured checklist. Multivariable multinomial logistic regression model was undertaken to identify the contributing factors. Results At the end of the intensive phase, 17.3% of MDRTB patients had an unfavorable treatment outcome while 16.8% had an unknown outcome with the rest having a favorable outcome. The median duration of the intensive phase was 9.0 months (IQR 8.04-10.54). Having an unfavorable intensive phase treatment outcome was found to be more common among older aged [ARRR= 1.047, 95% CI (1.024, 1.072)] and those without a history of hypokalemia [ARRR=0.512, 95% CI (0.280, 0.939)]. Having an unknown intensive phase treatment outcome was found to be more common among those treated under the ambulatory care model [ARRR=3.2, 95% CI (1.6, 6.2)], rural dwellers [ARRR= 0.370, 95% CI (0.199, 0.66)], those without a treatment supporter [ARRR=0.022, 95% CI (0.002, 0.231)], and those with resistance to a limited number of drugs. Conclusion We observed a higher than anticipated rate of unfavorable and unknown treatment outcomes in this study. To improve favorable treatment outcome more emphasis should be given to conducting all scheduled laboratory monitoring tests, assignment of trained treatment supporters and ensuring complete recording and reporting which could be enhanced by quarterly cohort review. Older aged and rural patients need special attention. Furthermore, the sample referral network should be strengthened.

scholarly journals Intensive phase treatment outcome and associated factors among patients treated for multi drug resistant tuberculosis in Ethiopia: a retrospective cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Teklu Molie ◽  
Zelalem Teklemariam ◽  
Eveline Klinkenberg ◽  
Yadeta Dessie ◽  
Andargachew Kumsa ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Retrospective Cohort ◽  
Multinomial Logistic Regression ◽  
Drug Resistant ◽  
Contributing Factors ◽  
Drug Resistant Tuberculosis ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Abstract Background Multi-drug resistant Tuberculosis (MDR-TB) is a strain of Mycobacterium tuberculosis that is resistant to at least Rifampicin and Isoniazid drugs. The treatment success rate for MDR-TB cases is lower than for drug susceptible TB. Globally only 55% of MDR-TB patients were successfully treated. Monitoring the early treatment outcome and better understanding of the specific reasons for early unfavorable and unknown treatment outcome is crucial for preventing the emergence of further drug-resistant tuberculosis. However, this information is scarce in Ethiopia. Therefore, this study aimed to determine the intensive phase treatment outcome and contributing factors among patients treated for MDR-TB in Ethiopia. Methods A 6 year retrospective cohort record review was conducted in fourteen TICs all over the country. The records of 751 MDR-TB patients were randomly selected using simple random sampling technique. Data were collected using a pre-tested and structured checklist. Multivariable multinomial logistic regression was undertaken to identify the contributing factors. Results At the end of the intensive phase, 17.3% of MDR-TB patients had an unfavorable treatment outcome, while 16.8% had an unknown outcome with the remaining having a favorable outcome. The median duration of the intensive phase was 9.0 months (IQR 8.04–10.54). Having an unfavorable intensive phase treatment outcome was found significantly more common among older age [ARRR = 1.047, 95% CI (1.024, 1.072)] and those with a history of hypokalemia [ARRR = 0.512, 95% CI (0.280, 0.939)]. Having an unknown intensive phase treatment outcome was found to be more common among those treated under the ambulatory care [ARRR = 3.2, 95% CI (1.6, 6.2)], rural dwellers [ARRR = 0.370, 95% CI (0.199, 0.66)], those without a treatment supporter [ARRR = 0.022, 95% CI (0.002, 0.231)], and those with resistance to a limited number of drugs. Conclusion We observed a higher rate of unfavorable and unknown treatment outcome in this study. To improve favorable treatment outcome more emphasis should be given to conducting all scheduled laboratory monitoring tests, assignment of treatment supporters for each patient and ensuring complete recording and reporting which could be enhanced by quarterly cohort review. Older aged and rural patients need special attention. Furthermore, the sample referral network should be strengthened.

scholarly journals Intensive Phase Treatment Outcome and Associated Factors among Patients Treated for Multi Drug Resistant Tuberculosis in Ethiopia: A retrospective cohort study

2019 ◽  
Author(s):  
Teklu Molie ◽  
Zelalem Teklemariam ◽  
Eveline Klinkenberg ◽  
Yadeta Dessie ◽  
Andargachew Kumsa ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Retrospective Cohort ◽  
Multinomial Logistic Regression ◽  
Drug Resistant ◽  
Contributing Factors ◽  
Drug Resistant Tuberculosis ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Abstract Background : Multi-drug resistant Tuberculosis (MDR-TB) is a strain of Mycobacterium tuberculosis that is resistant to at least Rifampicin and Isoniazid drugs. The treatment success rate for MDR-TB cases is lower than for drug susceptible TB. Globally only 55% of MDR-TB patients were successfully treated. Monitoring the early treatment outcome and better understanding of the specific reasons for early unfavorable and unknown treatment outcome is crucial for preventing the emergence of further drug-resistant tuberculosis. However, this information is scarce in Ethiopia. Therefore, this study aimed to determine the intensive phase treatment outcome and contributing factors among patients treated for MDR-TB in Ethiopia. Methods : A 6 year retrospective cohort record review was conducted in fourteen TICs all over the country. The records of 751 MDR-TB patients were randomly selected using simple random sampling technique. Data were collected using a pre-tested and structured checklist. Multivariable multinomial logistic regression was undertaken to identify the contributing factors. Results: At the end of the intensive phase, 17.3% of MDR-TB patients had an unfavorable treatment outcome, while 16.8% had an unknown outcome with the remaining having a favorable outcome. The median duration of the intensive phase was 9.0 months (IQR 8.04-10.54). Having an unfavorable intensive phase treatment outcome was found significantly more common among older age [ARRR= 1.047, 95% CI (1.024, 1.072)] and those without a history of hypokalemia [ARRR=0.512, 95% CI (0.280, 0.939)]. Having an unknown intensive phase treatment outcome was found to be more common among those treated under the ambulatory care [ARRR=3.2, 95% CI (1.6, 6.2)], rural dwellers [ARRR= 0.370, 95% CI (0.199, 0.66)], those without a treatment supporter [ARRR=0.022, 95% CI (0.002, 0.231)], and those with resistance to a limited number of drugs. Conclusion: We observed a higher rate of unfavorable and unknown treatment outcome in this study. To improve favorable treatment outcome more emphasis should be given to conducting all scheduled laboratory monitoring tests, assignment of treatment supporters for each patient and ensuring complete recording and reporting which could be enhanced by quarterly cohort review. Older aged and rural patients need special attention. The sample referral network should be strengthened.

Exploring patient-provider factors for risk of developing Multi-drug Resistance Tuberculosis in Southern Ethiopia: Qualitative Operation Research (Preprint)

2019 ◽  
Author(s):  
Yitagesu Habtu ◽  
Tesema Bereku ◽  
Girma Alemu ◽  
Ermias Abera
Keyword(s):  
Phenomenological Study ◽  
Treatment Success ◽  
World Health ◽  
Multi Drug Resistance ◽  
Southern Ethiopia ◽  
Drug Resistant ◽  
Related Factors ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis

BACKGROUND Ethiopia is one of among thirty high burden countries of multi-drug resistant tuberculosis (MDR-TB) in the regions of world health organization. Contextual evidence on the emergence of the disease is limited at a program level. OBJECTIVE The aim of the study is to explore patient-provider factors that may facilitate the emergence of multi-drug resistant tuberculosis. METHODS We used a phenomenological study design of qualitative approach from June to July, 2015. We conducted ten in-depth interviews and 4 focus group discussions with purposely selected patients and providers. We designed and used an interview guide to collect data. Verbatim transcribes were exported to open code 3.4 for emerging thematic analysis. Domain summaries were used to support core interpretation. RESULTS The study explored patient-provider factors facilitating the emergence of multi-drug resistant tuberculosis. These factors as underlying, health system and patient-related factors. Especially, the a shows conflicting finding between having a history of discontinuing drug-susceptible tuberculosis and emergence of multi-drug resistant tuberculosis. CONCLUSIONS The patient-provider factors may result in poor early case identification, adherence to and treatment success in drug sensitive or multi-drug resistant tuberculosis. Our study implies the need for awareness creation about multi-drug resistant tuberculosis for patients and further familiarization for providers. This study also shows that patients developed multi-drug resistant tuberculosis though they had never discontinued their drug-susceptible tuberculosis treatment. Therefore, further studies may require for this discording finding.

scholarly journals Multi-Drug Resistant Tuberculosis Treatment Outcome and Associated Factors in Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study

2020 ◽  
Author(s):  
Tadesse Alemu Bekele ◽  
Getasew Amogne Aynalem ◽  
Trhas Tadesse Berhe
Keyword(s):  
Treatment Outcome ◽  
Cross Sectional Study ◽  
Drug Resistant ◽  
Sectional Study ◽  
Cross Sectional ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Poor Treatment ◽  
Poor Treatment Outcome

Abstract BackgroundDrug-resistant tuberculosis continues to be a public health threat around the globe especially in developing countries. In 2018, the number of new cases of rifampicin-resistant tuberculosis was half a million and about 78% of them had multi-drug resistant tuberculosis. In Ethiopia, the overall proportion of multi-drug resistant tuberculosis was 11.6%. The latest treatment outcome data for people with multi-drug resistant tuberculosis show a global treatment success rate of 56%. Therefore, this study was aimed at assessing multi-drug resistant tuberculosis treatment outcomes and associated factors at St. Peter Specialized Hospital, Ethiopia, 2019. MethodsA retrospective cross-sectional study was done. A total of 384 patient medical charts selected by simple random sampling method were reviewed. The data was collected using a checklist from the patients’ medical charts. The collected data were analyzed with SPSS version 23 computer software package. Summary statistics of a given data for each variable were calculated. A logistic regression model was used to measure the association between the outcome and the predictor variable. Statistical significance was declared at p-value<0.05. Direction and strength of association were expressed using OR and 95% CI. ResultFrom a total of 384 patients, the majority of 245(63.8%) of the study subjects were females. The rate of poor treatment outcome was 173(45.1%). Male patients and patients in the age category of 39-60 years were less likely to have poor treatment outcome compared to female patients and patients in the age category of 18-38 years (AOR = 0.43, 95%CI (0.19, 0.10) and (AOR = 0.28, 95%CI (0.15, 0.52) respectively. Patients with a history of second-line TB drug resistance are more likely to have poor treatment outcomes (AOR = 3.81, 95%CI (1.84, 7.91). Poor treatment outcome was higher among patients with longer treatment duration (AOR = 3.23, 95%CI (1.82, 5.74) compared to patients with short treatment duration. ConclusionThe proportion of poor treatment outcome in patients with multi-drug resistant tuberculosis was high. Therefore, a concerted effort should be done at all levels to improve the treatment outcome of the MDR-TB.

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