Treatment outcomes of patients with tuberculosis in war affected region of Khyber Pakhtunkhwa, Pakistan

Abstract Background: Globally, tuberculosis (TB) remains the leading cause of death from a single infectious disease. TB treatment outcome is an indicator for the effectiveness of a national TB control program. This study aimed to assess treatment outcomes of TB patients and its determinants in Batkhela, Khyber Pakhtunkhwa, Pakistan. Methods: A retrospective cohort study was designed using all TB patients who were enrolled at District Head Quarter (DHQ) Hospital Batkhela, Pakistan, from January 2011 to December 2014. A binary logistic regression models were used to identify factors associated with successful TB treatment outcomes defined as the sum of cure and completed treatment. Results: A total of 515 TB patients were registered, of which 237 (46%) were males and 278 (53.98%) females. Of all patients, 234 (45.44%) were cured and 210 (40.77%) completed treatment. The overall treatment success rate was 444 (86.21%). Age 0-20 years (adjusted odds ratio, AOR= 3.47; 95% confidence interval, CI)= 1.54-7.81; P= 0.003), smear-positive pulmonary TB (AOR)= 3.58; 95% CI= 1.89-6.78; P= <0.001), treatment category (AOR= 4.71; 95% CI= 1.17-18.97; P= 0.029), and year of enrollment 2012 (AOR= 6.26; 95% CI= 2.52-15.59; P= <0.001) were significantly associated with successful treatment outcome. Conclusions: The overall treatment success rate is satisfactory but still need to be improved to achieve the international targeted treatment outcome. Type of TB, age, treatment category, and year of enrollment were significantly associated with successful treatment outcomes.

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Treatment outcomes of patients with tuberculosis in war affected region of Khyber Paktunkhwa, Pakistan

10.21203/rs.2.9219/v2 ◽

2019 ◽

Author(s):

TAUSEEF AHMAD ◽

Muhammad Ayub Jadoon ◽

Muhammad Khan ◽

Muhammad Mumtaz Khan ◽

Akbar Hussain ◽

...

Keyword(s):

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Successful Treatment ◽

Treatment Success ◽

Control Program ◽

Treatment Success Rate ◽

Logistic Regression Models ◽

Tb Treatment ◽

Treatment Category

Abstract Background: Globally, tuberculosis (TB) remains the leading cause of death from a single infectious disease. TB treatment outcome is an indicator for the effectiveness of a national TB control program. This study aimed to assess treatment outcomes of TB patients and its determinants in Batkhela, Khyber Pakhtunkhwa, Pakistan. Methods: A retrospective cohort study was designed using all TB patients who were enrolled at District Head Quarter (DHQ) Hospital Batkhela, Pakistan, from January 2011 to December 2014. A multivariable logistic regression models were used to identify factors associated with successful TB treatment outcomes defined as the sum of cure and completed treatment. Results: A total of 515 TB patients were registered, of which 237 (46%) were males and 278 (53.98%) females. Of all patients, 234 (45.44%) were cured and 210 (40.77%) completed treatment. The overall treatment success rate was 444 (86.21%). Age 0-20 years (adjusted odds ratio, AOR= 3.47; 95% confidence interval, CI)= 1.54-7.81; P= 0.003), smear-positive pulmonary TB (AOR)= 3.58; 95% CI= 1.89-6.78; P= <0.001), treatment category (AOR= 4.71; 95% CI= 1.17-18.97; P= 0.029), and year of enrollment 2012 (AOR= 6.26; 95% CI= 2.52-15.59; P= <0.001) were significantly associated with successful treatment outcome. Conclusions: The overall treatment success rate is satisfactory but still need to be improved to achieve the international targeted treatment outcome. Type of TB, age, treatment category, and year of enrollment were significantly associated with successful treatment outcomes.

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Analysis of Treatment Outcome in Patients with Tuberculosis in War Affected Region of Khyber Paktunkhwa, Pakistan

10.21203/rs.2.9219/v1 ◽

2019 ◽

Author(s):

TAUSEEF AHMAD ◽

Muhammad Ayub Jadoon ◽

Muhammad Khan ◽

Muhammad Mumtaz Khan ◽

Akbar Hussain ◽

...

Keyword(s):

Treatment Outcome ◽

Success Rate ◽

Successful Treatment ◽

Treatment Success ◽

Case Fatality ◽

Treatment Success Rate ◽

Control Programs ◽

Successful Treatment Outcome ◽

Tb Treatment ◽

Treatment Category

Abstract ABSTRACT Background Globally, tuberculosis (TB) remains the leading cause of death from a single infectious disease. TB treatment outcome is an indicator for the effectiveness of a national TB control programs. This study aimed to assess treatment outcome of TB patients and its determinants in Batkhela, Khyber Pakhtunkhwa, Pakistan. Methods A retrospective cohort study was designed using all TB patients who were enrolled at District Head Quarter (DHQ) Hospital Batkhela, Pakistan. Distribution of TB types, treatment outcome and associated factor with successful treatment was computed using SPSS version 20.0 software for windows. Results A total of 515 TB patients were registered, of which 237 (46%) were males and 278 (53.98%) females. Of the total, 234 (45.44%) were cured and 210 (40.77%) completed treatment with overall treatment success rate was 444 (86.21%). Age 0-20 years (AOR= 3.47; 95% CI= 1.54-7.81; P= 0.003), smear-positive pulmonary TB (SPPTB) (AOR= 3.58; 95% CI= 1.89-6.78; P= <0.001), treatment category (AOR= 4.71; 95% CI= 1.17-18.97; P= 0.029), and year of enrollment 2012 (AOR= 6.26; 95% CI= 2.52-15.59; P= <0.001) were significantly associated with successful treatment outcome. Conclusions The overall treatment success rate is satisfactory but still need to be improved to achieve the international targeted treatment outcome. An increase was observed in overall case-fatality rate during the study duration which is an alarming signal for public health.

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Treatment Outcomes and Associated Factors in Tuberculosis Patients at Atwima Nwabiagya District, Ashanti Region, Ghana: A Ten-Year Retrospective Study

Tuberculosis Research and Treatment ◽

10.1155/2021/9952806 ◽

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.

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Trends of Tuberculosis Treatment Outcomes of Notified Cases in Three Refugee Camps in Sudan: A Four-year Retrospective Analysis, 2014–2017

Sudan Journal of Medical Sciences ◽

10.18502/sjms.v16i2.9293 ◽

2021 ◽

Author(s):

Tsegay Legesse ◽

Mohammed Hussein Elduma ◽

Nagi Masoud Awad ◽

Mousab Siddig Elhag ◽

Israa Abushama ◽

...

Keyword(s):

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Treatment Success ◽

Treatment Success Rate ◽

Refugee Camps ◽

Historical Cohort ◽

Tb Treatment ◽

Unsuccessful Treatment ◽

Lost To Follow Up

Background: Refugees are vulnerable to tuberculosis (TB) infection. Tracking of program performance is needed to improve TB care and prevention. The objective of this study was to assess the trends of TB treatment outcomes of notified cases in three refugee camps in Sudan from 2014 to 2017. Methods: This study was a historical cohort study. Sex, age, type of TB, TB patient category, and treatment outcome of all TB cases registered in three refugee camps (Al Kashafa, Shagarab, Wadsherify) from January 1, 2014 to December 31, 2017 were collected from the TB register. Multivariable logistic regression was performed to explore factors for unsuccessful TB treatment. Results: A total of 710 TB cases of which 53.4% were men, 22.1% children (<15 years), and 36.2% extrapulmonary TB (EPTB) were registered. Overall, the TB treatment success rate was 75.7% with a declining trend from 86.2% in 2015 to 63.5% in 2017. On average, 11.4% were lost to follow-up (LTFU), 6.6% died, 5.9% were not evaluated, and in 0.3% the treatment failed. Being 15–24 years old and having EPTB were significantly associated with unsuccessful treatment outcome. Conclusion: The treatment success rate in the refugee camp in 2017 (63.5%) was far lower than the national treatment success rate (78%) and the End TB global target (≥90%) that needs to be improved. LTFU, died, and not evaluated outcomes were high which indicated the necessity to improve the TB treatment program.

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Knowledge about tuberculosis, treatment adherence and outcome among ambulatory patients with drug-sensitive tuberculosis in two directly-observed treatment centres in Southwest Nigeria

BMC Public Health ◽

10.1186/s12889-021-10698-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rasaq Adisa ◽

Teju T. Ayandokun ◽

Olusoji M. Ige

Keyword(s):

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Treatment Success ◽

Healthcare Facility ◽

Treatment Success Rate ◽

Categorical Variables ◽

Cross Sectional ◽

Tb Treatment ◽

Directly Observed Treatment

Abstract Background Tuberculosis (TB) remains one of the most common infectious diseases worldwide. Although TB is curable provided the treatment commenced quickly, appropriately and uninterrupted throughout TB treatment duration. However, high default rate, treatment interruption and therapy non-adherence coupled with inadequate disease knowledge significantly contribute to poor TB treatment outcome, especially in developing countries. This study therefore assessed knowledge about TB and possible reasons for treatment non-adherence among drug-sensitive TB (DS-TB) patients, as well as evaluated treatment outcomes for the DS-TB managed within a 5-year period. Methods A mixed-method design comprising a cross-sectional questionnaire-guided survey among 140-ambulatory DS-TB patients from January–March 2019, and a retrospective review of medical-records of DS-TB managed from 2013 to 2017 in two WHO-certified TB directly-observed-treatment centres. Data were summarized using descriptive statistics, while categorical variables were evaluated with Chi-square at p < 0.05. Results Among the prospective DS-TB patients, males were 77(55.0%) and females were 63(45.0%). Most (63;45.0%) belonged to ages 18-34 years. A substantial proportion knew that TB is curable (137;97.9%) and transmittable (128;91.4%), while 107(46.1%) accurately cited coughing without covering the mouth as a principal mode of transmission. Only 10(4.0%) mentioned adherence to TB medications as a measure to prevent transmission. Inaccessibility to healthcare facility (33;55.0%) and pill-burden (10,16.7%) were topmost reasons for TB treatment non-adherence. Of the 2262-DS-TB patients whose treatment outcomes were evaluated, 1211(53.5%) were cured, 580(25.6%) had treatment completed, 240(10.6%) defaulted, 54(2.3%) failed treatment and 177(7.8%) died. Overall, the treatment success rate within the 5-year period ranged from 77.4 to 81.9%. Conclusions Knowledge about TB among the prospective DS-TB patients is relatively high, especially with respect to modes of TB transmission and preventive measures, but a sizeable number lacks the understanding of ensuring optimal TB medication-adherence to prevent TB transmission. Inaccessibility to healthcare facility largely accounts for treatment non-adherence. Outcomes of treatment within the 5-year period show that nearly half were cured, while almost one-tenth died. Overall treatment success rate is about 12% below the WHO-defined target. There is generally a need for concerned stakeholders to step-up efforts in ensuring consistent TB enlightenment, while improving access to TB care is essential for better treatment outcome.

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Drug-susceptible tuberculosis treatment success and associated factors in Ethiopia from 2005 to 2017: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-022111 ◽

2018 ◽

Vol 8 (9) ◽

pp. e022111 ◽

Cited By ~ 7

Author(s):

Mohammed Assen Seid ◽

Mohammed Biset Ayalew ◽

Esileman Abdela Muche ◽

Eyob Alemayehu Gebreyohannes ◽

Tadesse Melaku Abegaz

Keyword(s):

Systematic Review ◽

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Meta Analysis ◽

Treatment Success ◽

Systematic Search ◽

Treatment Success Rate ◽

Rural Residence ◽

Tb Treatment

ObjectivesThe main aim of this study was to assess the overall tuberculosis (TB) treatment success in Ethiopia and to identify potential factors for poor TB treatment outcome.DesignA systematic review and meta-analysis of published literature was conducted. Original studies were identified through a computerised systematic search using PubMed, Google Scholar and Science Direct databases. Heterogeneity across studies was assessed using Cochran’s Q test and I2statistic. Pooled estimates of treatment success were computed using the random-effects model with 95% CI using Stata V.14 software.ResultsA total of 230 articles were identified in the systematic search. Of these 34 observational studies were eligible for systematic review and meta-analysis. It was found that 117 750 patients reported treatment outcomes. Treatment outcomes were assessed by World Health Organization (WHO) standard definitions of TB treatment outcome. The overall pooled TB treatment success rate in Ethiopia was 86% (with 95% CI 83%_88%). TB treatment success rate for each region showed that, Addis Ababa (93%), Oromia (84%), Amhara (86%), Southern Nations (83%), Tigray (85%) and Afar (86%). Mainly old age, HIV co-infection, retreatment cases and rural residence were the most frequently identified factors associated with poor TB treatment outcome.ConclusionThe result of this study revealed that the overall TB treatment success rate in Ethiopia was below the threshold suggested by WHO (90%). There was also a discrepancy in TB treatment success rate among different regions of Ethiopia. In addition to these, HIV co-infection, older age, retreatment cases and rural residence were associated with poor treatment outcome. In order to further improve the treatment success rate, it is strategic to give special consideration for regions which had low TB treatment success and patients with TB with HIV co-infection, older age, rural residence and retreatment cases.

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Tuberculosis treatment outcome and associated factors among tuberculosis patients at Wolayta Sodo Teaching and Referral Hospital, Southern Ethiopia: a retrospective study

Journal of Public Health Research ◽

10.4081/jphr.2021.2046 ◽

2021 ◽

Author(s):

Melese Yeshambaw Teferi ◽

Lukas Dingato Didana ◽

Tsegaye Hailu ◽

Simon Genet Woldesenbet ◽

Senedu Bekele ◽

...

Keyword(s):

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Associated Factors ◽

Treatment Success ◽

Referral Hospital ◽

Treatment Success Rate ◽

Tb Treatment ◽

Lost To Follow Up

Background: Tuberculosis is a major public health problem throughout the world particularly in resource limited countries. Measuring and reporting of TB treatment outcomes and identifying associated factors are fundamental part of TB treatment. The aim of this study was to assess TB treatment outcome and associated factors among TB patients in Wolayta Sodo Teaching and Referral Hospital, Southern Ethiopia.Design and Methods: Facility based retrospective cohort study was conducted in Wolayta Sodo Teaching and Referral Hospital. All TB patients who registered during September 2014 to August 2019 and had known treatment outcome were included in the study. The data were collected using pretested structured data extraction format that included demographic, clinical and treatment outcome variables. SPSS Version 23 for windows was used for data processing. Bivariate and multivariate analysis with 95% confidence interval (CI) was employed to infer associations between the independent and dependent variables.Results: Of total 232 TB patient included in the study, 54.3% were male,80.2% were urban residents, 65.9% were pulmonary TB (PTB). From the total 153 PTB cases,31.5% were smear positive, 17.2% were HIV co-infected and all of them were on antiretroviral treatment. Most, 97.0% of the TB cases were newly diagnosed and all were treated as first line treatment category. The overall treatment success rate was 82.5% (28% cured 54.3% completed), 11.2% loss to follow-up, 4.7% dead and 0.9% treatment failure. The treatment success rate of HIV co-infected TB patients was 77.5%. There was no significant association between TB treatment outcome and age, sex, residence, type of TB, category of patients and HIV status.Conclusions: The treatment success rate was low (82.5%) which is below the90% threshold defined standard with high proportion of patient’s lost to follow-up (11.2%). A higher number of transfer-out cases were recorded in this study. Thus, supervision and monitoring of DOTs implementation, improved counseling service, mechanisms for lost to follow-up patients should be strengthen. Establish efficient referral and contact tracing mechanisms for transferred-out cases and document their treatment outcomes of status is also fundamental.

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Treatment outcomes and their trend among tuberculosis patients treated at peripheral health settings of Northern Ethiopia Between 2009-2014: a registry-based retrospective analysis

10.21203/rs.2.11942/v4 ◽

2019 ◽

Author(s):

Mahmud Abdulkader ◽

Ischa van Aken ◽

Selam Sahle Niguse ◽

Haftamu Hailekiros ◽

Mark Spigt

Keyword(s):

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Trend Analysis ◽

Successful Treatment ◽

Treatment Success ◽

Treatment Success Rate ◽

Northern Ethiopia ◽

Pulmonary Tb ◽

Objective Evidence

Abstract Objective: Evidence on treatment outcomes and their trend analysis through a register based retrospective study have significant contributions in the improvement of a national tuberculosis program. This study was aimed at determining tuberculosis treatment outcomes and their trend analysis. Results: A total of 3445 patient records were included. More than half, (58%) were males and the mean age was 33.88 ± 16.91 years (range: 0-90). From the total TB patients, 18.8% were HIV co infected. The treatment outcome of TB patients were 371 (10.8%) cured, 2234 (64.8) treatment completed, died 119 (3.5%) died, 9 (0.3%) failed, 178 (5.1%) defaulted and 534 (15.5%) were transferred out. The overall treatment success rate was 89.5%. When assessed on yearly basis, treatment success rate was 87% in year 2009-2010 to 92.8% in 2013-2014 with 6.67% change in the outcome indicator over the five years period. Among pulmonary TB, pulmonary negative TB and extra pulmonary TB, the rate of successful treatment outcome was 83.1% to 89%, 85.1% to 89.4%, and 87.4% to 92%, respectively in the year 2009-2010 to 2013-2014. The percentage of the overall successful treatment outcomes were significantly associated with the year of treatment (p=0.014).

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Treatment outcomes and factors associated with “successful treatment” among tuberculosis patients at peripheral health settings of Northern Ethiopia: a registry-based retrospective case-series analysis.

10.21203/rs.2.11942/v3 ◽

2019 ◽

Author(s):

Mahmud Abdulkader ◽

Ischa van Aken ◽

Selam Sahle Niguse ◽

Haftamu Hailekiros ◽

Mark Spigt

Keyword(s):

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Successful Treatment ◽

Treatment Success ◽

Treatment Success Rate ◽

Northern Ethiopia ◽

Pulmonary Tb ◽

Factors Associated ◽

Objective Evidence

Abstract Objective: Evidence on treatment outcomes and identifying factors facilitating treatment success through a register based retrospective study have significant contribution in the improvement of a national tuberculosis program. This study was aimed at determining treatment outcomes and factors associated with “successful treatment” outcomes. Results: A total of 3445 patient records were included. More than half, (58%) were males and the mean age was 33.88 ± 16.91 years (range: 0-90). From the total TB patients, 18.8% were HIV co infected. The treatment outcome of TB patients were 371 (10.8%) cured, 2234 (64.8) treatment completed, died 119 (3.5%) died, 9 (0.3%) failed, 178 (5.1%) defaulted and 534 (15.5%) were transferred out. The overall treatment success rate was 89.5%. The overall treatment success rate was 87% in year 2009-2010 to 92.8% in 2013-2014 with 6.67% change in the outcome indicator over the five years period. Among pulmonary TB, pulmonary negative TB and extra pulmonary TB the rate of successful treatment outcome was 83.1% to 89%, 85.1% to 89.4%, and 87.4% to 92%, respectively in the year 2009-2010 to 2013-2014. The percentage of the overall successful treatment outcomes were significantly associated with the year of treatment (p- =0.014).

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Treatment outcomes and their trend among tuberculosis patients treated at peripheral health settings of Northern Ethiopia between 2009 and 2014: a registry-based retrospective analysis

BMC Research Notes ◽

10.1186/s13104-019-4824-9 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Mahmud Abdulkader ◽

Ischa van Aken ◽

Selam Niguse ◽

Haftamu Hailekiros ◽

Mark Spigt

Keyword(s):

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Trend Analysis ◽

Successful Treatment ◽

Treatment Success ◽

Treatment Success Rate ◽

Northern Ethiopia ◽

Pulmonary Tb ◽

Successful Treatment Outcome

Abstract Objective Evidence on treatment outcomes and their trend analysis through a register based retrospective study have significant contributions in the improvement of a national tuberculosis program. This study was aimed at determining tuberculosis treatment outcomes and their trend analysis. Results A total of 3445 patient records were included. More than half (58%) were males and the mean age was 33.88 ± 16.91 years (range 0–90). From the total TB patients, 18.8% were HIV co infected. The treatment outcome of TB patients were 371 (10.8%) cured, 2234 (64.8) treatment completed, 119 (3.5%) died, 9 (0.3%) failed, 178 (5.1%) defaulted and 534 (15.5%) were transferred out. The overall treatment success rate was 89.5%. When assessed on yearly basis, treatment success rate was 87% in year 2009–2010 to 92.8% in 2013–2014 with 6.67% change in the outcome indicator over the 5 years period. Among pulmonary TB, pulmonary negative TB and extra pulmonary TB, the rate of successful treatment outcome was 83.1% to 89%, 85.1% to 89.4%, and 87.4% to 92%, respectively in the year 2009–2010 to 2013–2014. The percentage of the overall successful treatment outcomes were significantly associated with the year of treatment (p = 0.014).

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