Tuberculosis (TB) in the refugee camps in Ethiopia: Trends of case notification, profile, and treatment outcomes, 2014 to 2017

Abstract Background: Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to improve the effectiveness of TB programs. This study aimed to investigate trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. Methods: In this retrospective cohort study, demographic and clinical data of all TB cases registered in 25 refugee camps in Ethiopia from January 2014 to December 2017 were extracted. Multivariate logistic regression was fitted to estimate odds ratios and corresponding 95% confidence intervals for the measure of association linked with factors significantly associated with unsuccessful treatment outcomes. Results: A total of 1553 TB cases, mean age 27.7 years, were registered from 2014 to 2017. Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in number of notified TB cases (138 to 588 cases), in percentage of EPTB (23.2% to 32.7%), in contribution of children to total TB cases (18.8% to 30.1%) and to EPTB (40.6% to 65.1%), and in proportion of bacteriologically confirmed new and relapse pulmonary cases (43.8% to 64.8%). Treatment success rates for all TB cases remained lower at 72.7%-79.4%. On average 24.8% had unfavorable treatment outcome, including 11.5% not evaluated, 8.0% LTFU, 4.8% died and 0.5% treatment failed. Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive. Conclusions: There was continuous increase in notified TB cases and in percentage of childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases increased overtime. TB treatment success remained lower than the national achievement in 2017 (96%) and global target (>=90%), which needs improvement. The higher LTFU, not evaluated, and death suggests the need to strengthen adherence education and supervision. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives.

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Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017

BMC Infectious Diseases ◽

10.1186/s12879-021-05828-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tsegay Legesse ◽

Goitom Admenur ◽

Selemawit Gebregzabher ◽

Eyob Woldegebriel ◽

Bexabeh Fantahun ◽

...

Keyword(s):

Treatment Outcome ◽

Treatment Outcomes ◽

Treatment Success ◽

Refugee Camps ◽

Success Rates ◽

Continuous Increase ◽

Unsuccessful Treatment ◽

Childhood Tb ◽

Measure Of Association ◽

Case Notification

Abstract Background Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to improve the effectiveness of TB programs. This study aimed to investigate trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. Methods In this retrospective cohort study, demographic and clinical data of all TB cases registered in 25 refugee camps in Ethiopia from January 2014 to December 2017 were extracted. Multivariate logistic regression was fitted to estimate odds ratios and corresponding 95% confidence intervals for the measure of association linked with factors significantly associated with unsuccessful treatment outcomes. Results A total of 1553 TB cases, mean age 27.7 years, were registered from 2014 to 2017. Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in number of notified TB cases (138 to 588 cases), in percentage of EPTB (23.2 to 32.7%), in contribution of children to total TB cases (18.8 to 30.1%) and to EPTB (40.6 to 65.1%), and in proportion of bacteriologically confirmed new and relapse pulmonary cases (43.8 to 64.8%). Treatment success rates for all TB cases remained lower at 72.7–79.4%. On average 24.8% had unfavorable treatment outcome, including 11.5% not evaluated, 8.0% LTFU, 4.8% died and 0.5% treatment failed. Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive. Conclusions There was continuous increase in notified TB cases and in percentage of childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases increased overtime. TB treatment success remained lower than the national achievement in 2017 (96%) and global target (> = 90%), which needs improvement. The higher LTFU, not evaluated, and death suggests the need to strengthen adherence education and supervision. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives.

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Tuberculosis (TB) in the refugee camps in Ethiopia: Trends of case notification, profile, and treatment outcomes, 2014 to 2017

10.21203/rs.3.rs-52830/v2 ◽

2020 ◽

Author(s):

Tsegay Legesse ◽

Goitom Admenur ◽

Selemawit Gebregzabher ◽

Eyob Woldegebriel ◽

Bexabeh Fantahun ◽

...

Keyword(s):

Treatment Outcome ◽

Treatment Outcomes ◽

Treatment Success ◽

Refugee Camps ◽

Success Rates ◽

Continuous Increase ◽

Unsuccessful Treatment ◽

Childhood Tb ◽

Measure Of Association ◽

Case Notification

Abstract Background: Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to improve the effectiveness of TB programs. This study aimed to investigate trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia.Methods: In this retrospective cohort study, demographic and clinical data of all TB cases registered in 25 refugee camps in Ethiopia from January 2014 to December 2017 were extracted. Multivariate logistic regression was fitted to estimate odds ratios and corresponding 95% confidence intervals for the measure of association linked with factors significantly associated with unsuccessful treatment outcomes.Results. A total of 1553 TB cases, mean age 27.7 years, were registered from 2014 to 2017. Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in number of notified TB cases (138 to 588 cases), in percentage of EPTB (23.2% to 32.7%), in contribution of children to total TB cases (18.8% to 30.1%) and to EPTB (40.6% to 65.1%), and in proportion of bacteriologically confirmed new and relapse pulmonary cases (43.8% to 64.8%). Treatment success rates for all TB cases remained lower at 72.7%-79.4%. On average 24.8% had unfavorable treatment outcome, including 11.5% not evaluated, 8.0% LTFU, 4.8% died and 0.5% treatment failed. Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive.Conclusions: There was continuous increase in notified TB cases and in percentage of childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases increased overtime. TB treatment success remained lower than the national achievement in 2017 (96%) and global target (>=90%), which needs improvement. The higher LTFU, not evaluated, and death suggests the need to strengthen adherence education and supervision. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives.

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Tuberculosis (TB) in the Refugee Camps in Ethiopia: Trends of Case Notification, Profile, and Treatment Outcomes, 2014 to 2017

10.21203/rs.3.rs-52830/v1 ◽

2020 ◽

Author(s):

Tsegay Legesse ◽

Goitom Admenur ◽

Selemawit Gebregzabher ◽

Eyob Woldegebriel ◽

Bexabeh Fantahun ◽

...

Keyword(s):

Treatment Outcomes ◽

Data Extraction ◽

Treatment Success ◽

Refugee Camps ◽

Success Rates ◽

Factors Associated ◽

Unsuccessful Treatment ◽

Economic Support ◽

Childhood Tb ◽

Case Notification

Abstract Background: Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to evaluate the effectiveness of TB programs. This study aimed to determine trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. Methods: This retrospective cohort study was conducted from October 2018-June 2019. Demographic and clinical data of all TB cases registered from 2014 to 2017 in 25 refugee camps located in seven refugee areas (Shire, Afar, Gambella, Asossa, Mizam, Jijiga, and Dollo Ado) were extracted using pre-tested data extraction format. Multivariate logistic regression was performed to calculate odds ratios and 95% confidence intervals for factors associated with unsuccessful outcomes.Results. A total of 1553 TB cases, mean age 27.7 years, were registered (2014-2017). Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in the number of notified TB cases (138 to 588 cases), in the percentage of EPTB (23.2% to 32.7%), bacteriologically confirmed pulmonary new and relapse (43.8% to 64.8%), and contribution of children to total TB cases (18.8% to 30.1%) and to EPTB (40.6% to 65.1%). Treatment success rates for all TB cases remained lower at 72.7%-79.4% (on average 11.7% were not evaluated, 8.0% lost to follow-up (LTFU), 4.8% died, and 0.5% failed). Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive.Conclusions: This study has provided valuable evidences that can help to improve the TB programs. There was increased trend in number of notified TB cases, and in proportion of EPTB, childhood TB, and bacteriologically confirmed pulmonary new and relapse cases. Treatment success rate (2014-2017) was far below global target (90%), and “not evaluated” and LTFU treatment outcomes were higher, which need to be improved. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives who at risk for unsuccessful treatment.

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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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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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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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Epidemiology of childhood tuberculosis and factors associated with unsuccessful treatment outcomes in Tigray, Ethiopia: a ten-year retrospective cross sectional study

BMC Public Health ◽

10.1186/s12889-019-7732-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Gebremeskel Mirutse ◽

Mingwang Fang ◽

Alemayehu Bayray Kahsay ◽

Xiao Ma

Keyword(s):

Treatment Outcome ◽

Treatment Outcomes ◽

Cross Sectional Study ◽

Sectional Study ◽

Hiv Status ◽

Cross Sectional ◽

Factors Associated ◽

The Past ◽

Unsuccessful Treatment ◽

Childhood Tb

Abstract Background Childhood TB is an indicator of a recent transmission of the disease in a community and it is estimated to constitute 15–20% of all TB cases in many of developing countries. However, only few studies which dominated by industrial countries were engaged to assess the situation. Therefore, this study was aimed to see epidemiology of childhood TB and factors associated with poor treatment outcome in developing country. Method Using retrospective cross-sectional study design; Socio-demographic and clinical data of children aged less than 15 years old, treated for all forms of TB in the past 10 years (2007–2016) was collected from randomly selected eight public hospitals of Tigray. Then, Univariate logistic regression and adjusted multivariate logistic regressions was done to identify variables which had association with unsuccessful treatment outcomes at P-value less than 0.05. Result In the past 10 years, a total of 13,345 Tuberculosis cases were observed. Of these, 1086 (8.1%) cases were children aged less than 15 years old. Sixty seven (6.2%) cases were smear positive. Among those that tested for HIV, 69 (8.3%) cases were TB/HIV co-infected. Of those with treatment outcome record 746 (88.7%) were successfully treated. Factors like being female (AOR, 1.79; 95% CI, 1.07–3.00), Age 0–5 years (AOR, 3.35; 95% CI, 2.11–5.33), Unknown HIV status (AOR, 2.44; 95% CI, 1.51–3.95) and pulmonary positive case (AOR, 2.56; 95% CI, 1.13–5.77), were more likely to have unsuccessful treatment outcome than their counterparts. Conclusion In Tigray 8.1% all TB cases were children age less than 15 years old. Childhood TB treatment outcome varied with sex, age and HIV status.

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Reflecting on tuberculosis case notification and treatment outcomes in the Volta region of Ghana: a retrospective pool analysis of a multicentre cohort from 2013 to 2017

Global Health Research and Policy ◽

10.1186/s41256-019-0128-9 ◽

2019 ◽

Vol 4 (1) ◽

Author(s):

Eric Osei ◽

Samuel Oppong ◽

Daniel Adanfo ◽

Bless Ativor Doepe ◽

Andrews Owusu ◽

...

Keyword(s):

Success Rate ◽

Treatment Outcomes ◽

Treatment Success ◽

World Health ◽

Treatment Success Rate ◽

Unsuccessful Treatment ◽

Treatment Interruptions ◽

Incidence And Mortality ◽

Volta Region ◽

Case Notification

Abstract Background Tuberculosis (TB) remains a petrified condition with a huge economic and health impact on families and health systems in Ghana. Monitoring of TB programme performance indicators can provide reliable data for direct measurement of TB incidence and mortality. This study reflects on the trends of TB case notification and treatment outcomes and makes comparison among 10 districts of the Volta region of Ghana. Methods This was a retrospective analysis of surveillance data of a cohort of TB cases from 2013 to 2017. Trends of case notification and treatment outcomes were examined and compared. Logistic regression was used to determine the independent relationship between patients and disease characteristics and unsuccessful treatment outcomes. Odds ratios, 95% confidence intervals and p-values were estimated. Results A gradual declining trend of case notification of all forms of TB was noticed, with an overall case notification rate (CNR) of 65 cases per 100,000 population during the period. A wide variation of case notification of TB was observed among the districts, ranging from 32 to 124 cases per 100,000 population. Similarly, treatment success rate decreased slightly from 83.1% during the first year to 80.2% in 2017, with an overall treatment success rate of 82.5% (95% CI: 81.3–83.8%). Treatment failure, death, and lost to follow up rates were 0.8% (range 0.5–1.2%), 13.5% (range 12.4–14.7%), and 3.1% (range 2.6–3.8%) respectively. The treatment success rate among districts ranged from 70.5% in South Tongu to 90.8% in Krachi West district. Returned after treatment interruption (Adjusted odds ratio [AOR]: 3.62; 95% CI: 1.66–7.91; P < 0.001) and TB/HIV co-infection (AOR: 1.94; 95% CI: 1.57–2.40; P < 0.001) predicts poor treatment outcomes. Conclusion Over the past five years, TB case notification and successful treatment outcomes did not significantly improve. Wide district variations in CNR was observed. The overall treatment success rate observed in this study is below the target of > 90% set by the World Health Organization’s (WHO) end TB strategy. Additionally, patients who returned to continue treatment after interruption and those who were co-infected with HIV strongly predict unsuccessful treatment outcomes. Sustained interventions to prevent treatment interruptions and improved management of co-morbidities can enhance treatment outcomes, as required to achieve the elimination goal.

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Trends and outcomes of tuberculosis among cases at directly observed short course treatment (DOTS) at the Tepi public Health Center Southwest Ethiopia

ScienceRise Biological Science ◽

10.15587/2519-8025.2020.213488 ◽

2020 ◽

pp. 13-19

Author(s):

Samuel Getachew ◽

Abel Sirna ◽

Abiyot Negash ◽

Abyot Asres

Keyword(s):

Public Health ◽

Logistic Regression ◽

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Health Center ◽

Successful Treatment ◽

Treatment Success ◽

Pulmonary Tb ◽

Unsuccessful Treatment

Background: Monitoring treatment outcomes and understanding the reasons for unsuccessful treatment have paramount importance for the tuberculosis control program. This study was designed to evaluate trends and treatment outcomes of tuberculosis patients at the Tepi Health Center and to identify the predictors of unsuccessful treatment outcome.Method: Retrospective review of TB cases, registered in the Tepi health center from 2011-2018, was conducted using data, extracted from medical records of TB patients. The structured data extraction form was prepared and used to extract socio-demographic, clinical and outcome data of study cases. The case definition and the treatment outcome of patients were ascertained and reported in accordance with the World Health Organization guideline. A binary logistic regression model was fit to identify predictors of unsuccessful outcome.Results: A total of 1651 TB patients, registered at the Tepi Public Health Center in between June 2011 and May 2018, were included in the study. Of all 924(56 %) were males and 1053 (63.8 %) cases were in between the age range of 15 and 35 years. HIV-status of 1019 TB cases was unknown and 189(11.4 %) of participants were HIV-positive. 457 (27.7 %) cases were diagnosed with extra pulmonary TB (EPTB) and 1194(72.3 %) were pulmonary TB patients, out of which 376(73.6 %) were smear-positive pulmonary TB (PTB+). The overall treatment success rate (TSR) of patients was 80.4 % (1327/1651), while it was 84.8 % (134/158), 80.2 % (410/511), and 78.3 % (148/189) among the transfer-in, PTB+, and HIV+ cases, respectively. Higher numbers of successful treatment outcomes were recorded among new (82.7 %) EPTB cases (84.7 %). The cure rate was 73.6 %(376/511) and 18(34/189) among patients with PTB+ and HIV+, respectively. Multiple logistic regression analysis indicated that residence sites (OR .763(.584, .996) and TB/HIV co-infection (OR 0.661(0.444, 0.985), were significantly associated with the treatment outcome. Rural residence was 27.1 % less likely to have successful treatment. There was significant heterogeneity in the odds of having successful treatment outcomes across years of initiating treatment.Conclusion: The treatment success rate among study cases was lower than the WHO’s target and further efforts like availability of TB clinics in nearby sites and reducing rate of HIV infection should be made to improve the rate of successful treatment outcome

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Unsuccessful treatment outcome and associated factors among smear-positive pulmonary tuberculosis patients in Kepong district, Kuala Lumpur, Malaysia

Journal of Health Research ◽

10.1108/jhr-10-2020-0478 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Fadly Syah Arsad ◽

Noor Hassim Ismail

Keyword(s):

Risk Factors ◽

Treatment Outcome ◽

Pulmonary Tuberculosis ◽

Treatment Outcomes ◽

Treatment Success ◽

Kuala Lumpur ◽

Contributing Factors ◽

Content Type ◽

Unsuccessful Treatment ◽

Smear Positive Pulmonary Tuberculosis

PurposeThe purpose of this study was to assess tuberculosis (TB) treatment outcomes among new smear-positive pulmonary tuberculosis (PTB) patients and identify the risk factors of unsuccessful treatment outcomes in Kepong district, Kuala Lumpur, Malaysia.Design/methodology/approachA retrospective cohort study was conducted using registry-based data from the Tuberculosis Information System (TBIS) between 2014 and 2018. Simple random sampling was used to select 734 males and 380 females from the TBIS registry. Smear-positive PTB patient's sociodemographic, clinical and behavioral characteristics were extracted and analyzed. Logistic regression was used to find the possible independent risk factors for unsuccessful treatment outcomes.FindingsThe treatment success rate was 77.20% (n = 860) which was still below the target set by the WHO (>90%). In total, 254 patients showed an unsuccessful treatment outcome: 106 died, 99 defaulted, 47 not evaluated and 2 showed treatment failure. Unsuccessful treatment outcome was significantly associated with older age, male gender, non-citizen, unemployment and being HIV positive.Originality/valueThe study focuses on all these contributing factors of unsuccessful treatment outcome for a better risk assessment and stratification of TB patients and identify effective surveillance and management strategies to strengthen the control programs of tuberculosis in Kepong district.

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