Tuberculosis Treatment Outcome and Predictors in Africa: A Systematic Review and Meta-Analysis

This review aimed to summarize and estimate the TB treatment success rate and factors associated with unsuccessful TB treatment outcomes in Africa. Potentially eligible primary studies were retrieved from PubMed and Google Scholar. The risk of bias and quality of studies was assessed using The Joanna Briggs Institute’s (JBI) appraisal criteria, while heterogeneity across studies was assessed using Cochran’s Q test and I2 statistic. Publication bias was checked using the funnel plot and egger’s test. The protocol was registered in PROSPERO, numbered CRD42019136986. A total of 26 eligible studies were considered. The overall pooled estimate of TB treatment success rate was found to be 79.0% (95% CI: 76–82%), ranging from 53% (95% CI: 47–58%) in Nigeria to 92% (95% CI: 90–93%) in Ethiopia. The majority of unsuccessful outcomes were attributed to 48% (95% CI: 40–57%) death and 47% (95% CI: 39–55%) of defaulter rate. HIV co-infection and retreatment were significantly associated with an increased risk of unsuccessful treatment outcomes compared to HIV negative and newly diagnosed TB patients with RR of 1.53 (95% CI: 1.36–1.71) and 1.48 (95% CI: 1.14–1.94) respectively. TB treatment success rate was 79% below the WHO defined threshold of 85% with significant variation across countries. Countries need to explore contextual underlining factors and more effort is required in providing TB preventive treatment, improve case screening and linkage for TB treatment among HIV high-risk groups and use confirmatory TB diagnostic modality. Countries in Africa need to strengthen counseling and follow-up, socio-economic support for patients at high risk of loss to follow-up and poor treatment success is also crucial for successful TB control programs.

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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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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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Effect of using electronic medication monitors on tuberculosis treatment outcomes in China: a longitudinal ecological study

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00818-3 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Ni Wang ◽

Lei Guo ◽

Hemant Deepak Shewade ◽

Pruthu Thekkur ◽

Hui Zhang ◽

...

Keyword(s):

Success Rate ◽

Treatment Outcomes ◽

Treatment Success ◽

Coverage Rate ◽

Treatment Success Rate ◽

County Level ◽

Time Data ◽

Tb Treatment ◽

Random Intercept ◽

Relative Change

Abstract Background In China, an indigenously developed electronic medication monitor (EMM) was designed and used in 138 counties from three provinces. Previous studies showed positive results on accuracy, effectiveness, acceptability, and feasibility, but also found some ineffective implementations. In this paper, we assessed the effect of implementation of EMMs on treatment outcomes. Methods The longitudinal ecological method was used at the county level with aggregate secondary programmatic data. All the notified TB cases in 138 counties were involved in this study from April 2017 to June 2019, and rifampicin-resistant cases were excluded. We fitted a multilevel model to assess the relative change in the quarterly treatment success rate with increasing quarterly EMM coverage rate, in which a mixed effects maximum likelihood regression using random intercept model was applied, by adjusting for seasonal trends, population size, sociodemographic and clinical characteristics, and clustering within counties. Results Among all 69 678 notified TB cases, the treatment success rate was slightly increased from 93.5% [95% confidence interval (CI): 93.0–94.0] in second quarter of 2018 to 94.9% (95% CI: 94.4–95.4) in second quarter of 2019 after implementing EMMs. There was a statistically significant effect between quarterly EMM coverage and treatment success rate after adjusting for potential confounders (P = 0.0036), increasing 10% of EMM coverage rate will lead to 0.2% treatment success rate augment. Besides, an increase of 10% of elderly or bacteriologically confirmed TB will lead to a decrease of 0.4% and 0.9% of the treatment success rate. Conclusions Under programmatic settings, we found a statistically significant effect between increasing coverage of EMM and treatment success rate at the county level. More prospective studies are needed to confirm the effect of using EMM on TB treatment outcomes. We suggest performing operational research on EMMs that provides real-time data under programmatic conditions in the future.

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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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Medication Event Monitoring System for Infectious Tuberculosis Treatment in Morocco: A Retrospective Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16030412 ◽

2019 ◽

Vol 16 (3) ◽

pp. 412 ◽

Cited By ~ 2

Author(s):

Seup Park ◽

Ilham Sentissi ◽

Seung Gil ◽

Won-Seok Park ◽

ByungKwon Oh ◽

...

Keyword(s):

Success Rate ◽

Monitoring System ◽

Treatment Success ◽

Treatment Success Rate ◽

Control Group ◽

Event Monitoring ◽

Tb Treatment ◽

The Mean ◽

Lost To Follow Up

Non-adherence to tuberculosis (TB) treatment is a barrier to effective TB control. We investigated the effectiveness of a Medication Event Monitoring System (MEMS) as a tailored adherence-promoting intervention in Morocco. We compared patients who received a MEMS (n = 206) with patients who received standard TB care (n = 141) among new active TB patients with sputum smear-positive. The mean total medication days were 141.87 ± 29.5 in the control group and 140.85 ± 17.9 in the MEMS group (p = 0.7147), and the mean age and sex were not different between the two groups (p > 0.05). The treatment success rate was significantly higher in the MEMS group than in the control group (odds ratio (OR): 4.33, 95% confidence interval (CI): 2.13–8.81, p < 0.001), and the lost to follow-up rate was significantly lower in the MEMS group than in the control group (OR: 0.03, 95% CI: 0.05–0.24, p < 0.001) after adjusting for sex, age, and health centers. The mean drug adherence rate in the first month was significantly higher in the MEMS group than in the control group (p = 0.023). MEMS increased TB treatment success rate and decreased the lost to follow-up rate overall for infectious TB patients in a Moroccan rural area.

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

10.21203/rs.2.9219/v3 ◽

2020 ◽

Author(s):

TAUSEEF AHMAD ◽

Muhammad Ayub Jadoon ◽

Muhammad Khan ◽

Haroon ◽

Muhammad Mumtaz Khan ◽

...

Keyword(s):

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Successful Treatment ◽

Treatment Success ◽

Control Program ◽

Treatment Success Rate ◽

Khyber Pakhtunkhwa ◽

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 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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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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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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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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