scholarly journals Factors associated with unfavourable treatment outcomes in people with HIV-associated tuberculosis in Armenia, 2015 to 2019

2021 ◽  
Vol 91 (1) ◽  
Author(s):  
Lilit Gevorgyan ◽  
Ruzanna Grigoryan ◽  
Kostyantyn Dumchev ◽  
Kristina Akopyan ◽  
Anush Khachatryan ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Treatment Outcomes ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Unfavourable Outcome ◽  
Factors Associated ◽  
Risk Of Death ◽  
Tb Treatment ◽  
Lost To Follow Up

To evaluate factors associated with tuberculosis (TB) treatment outcomes in human Immunodeficiency Virus-Associated (HIV) TB patients in Armenia, we conducted a nation-wide cohort study using routine programmatic data of all HIV-associated TB patients receiving TB treatment with first- or second-line drugs from 2015 to 2019. Data were obtained from the TB and HIV electronic databases. We analysed occurrence of the combined unfavourable outcome (failure, lost to follow-up, death and not evaluated) and death separately, and factors associated with both outcomes using Cox regression. There were 320 HIV-associated TB patients who contributed a total of 351 episodes of TB treatment. An unfavourable TB treatment outcome was registered in 155 (44.2%) episodes, including 85 (24.2%) due to death, 38 (10.8%) lost to follow up, 13 (3.7%) failure and 19 (5.4%) not evaluated. Multivariable analysis showed that receipt of Antiretroviral Treatment (ART) [ART start before TB treatment: adjusted hazard ratio (aHR)=0.3, 95% confidence interval (CI): 0.2-0.5, aHR=, 95% CI:, 95% CI:, 95% CI:TB meningitis (aHR=4.4, 95% CI: 1.6-11.9) increased the risk. The risk of death was affected by the same factors as above in addition to the low BMI (aHR=2.5, 95% CI: 1.3-4.5) and drug resistance (aHR=2.3, 95% CI: 1.0-5.4). In the subsample of episodes receiving ART, history of interruption of ART during TB treatment increased the risk of unfavourable outcome (aHR=2.1 95% CI: 1.2-3.9), while ART start during TB treatment was associated with lower risk of both unfavourable outcome (within first 8 weeks: aHR: 0.5, 95% CI: 0.3-0.9; after 8 weeks: aHR: 0.4, 95% CI: 0.2-1.0) and death (within first 8 weeks: aHR: 0.2, 95% CI: 0.1-0.4; after 8 weeks: aHR: 0.1, 95% CI: 0.01-0.3). The rates of unfavourable TB treatment outcomes, and death in particular, among HIV-associated TB patients in Armenia are high. Our findings emphasize the protective effect of ART and the importance of proper management of cases complicated by drug resistance or meningitis.  

scholarly journals Biologic refractory disease in rheumatoid arthritis: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis

2018 ◽  
Vol 77 (10) ◽  
pp. 1405-1412 ◽  
Author(s):  
Lianne Kearsley-Fleet ◽  
Rebecca Davies ◽  
Diederik De Cock ◽  
Kath D Watson ◽  
Mark Lunt ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cox Regression ◽  
Social Deprivation ◽  
Multivariable Analysis ◽  
British Society ◽  
National Study ◽  
Refractory Disease ◽  
Factors Associated ◽  
Biologics Register

ObjectivesBiologic disease-modifying antirheumatic drugs (bDMARDs) have revolutionised treatment and outcomes for rheumatoid arthritis (RA). The expanding repertoire allows the option of switching bDMARD if current treatment is not effective. For some patients, even after switching, disease control remains elusive. This analysis aims to quantify the frequency of, and identify factors associated with, bDMARD refractory disease.MethodsPatients with RA starting first-line tumour necrosis factor inhibitor in the British Society for Rheumatology Biologics Register for RA from 2001 to 2014 were included. We defined patients as bDMARD refractory on the date they started their third class of bDMARD. Follow-up was censored at last follow-up date, 30 November 2016, or death, whichever came first. Switching patterns and stop reasons of bDMARDs were investigated. Cox regression identified baseline clinical factors associated with refractory disease. Multiple imputation of missing baseline data was used.Results867 of 13 502 (6%) patients were bDMARD refractory; median time to third bDMARD class of 8 years. In the multivariable analysis, baseline factors associated with bDMARD refractory disease included patients registered more recently, women, younger age, shorter disease duration, higher patient global assessment, higher Health Assessment Questionnaire score, current smokers, obesity and greater social deprivation.ConclusionsThis first national study has identified the frequency of bDMARD refractory disease to be at least 6% of patients who have ever received bDMARDs. As the choice of bDMARDs increases, patients are cycling through bDMARDs quicker. The aetiopathogenesis of bDMARD refractory disease requires further investigation. Focusing resources, such as nursing support, on these patients may help them achieve more stable, controlled disease.

scholarly journals Brazilian cohort study of risk factors associated with unsuccessful outcomes of drug resistant tuberculosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patricia Bartholomay ◽  
Rejane Sobrino Pinheiro ◽  
Fernanda Dockhorn ◽  
Daniele Maria Pelissari ◽  
Wildo Navegantes de Araújo
Keyword(s):  
Treatment Outcomes ◽  
Illicit Drugs ◽  
Multinomial Logistic Regression ◽  
Multidrug Resistant ◽  
Individual Characteristics ◽  
Drug Resistant ◽  
Factors Associated ◽  
Four Blocks ◽  
Lost To Follow Up

Abstract Background Treatment outcomes were evaluated of a cohort of new pulmonary tuberculosis (TB) cases that were rifampicin resistant, multidrug-resistant, or extensively resistant during 2013 and 2014 in Brazil. The objective of this study is to identify factors associated with unfavorable treatment outcomes for drug-resistant TB cases. Methods The Brazilian Special Tuberculosis Treatment Information System (SITE-TB) was the main data source. The independent variables were classified into four blocks (block I: individual characteristics; block II: clinical characteristics and proposed treatment; block III: treatment follow-up characteristics; and block IV: TB history). The category of successful therapeutic outcome was compared with lost to follow-up, failure, and death. Considering the multiple outcomes as the dependent variable, the odds ratios (OR) and its respective 95% confidence interval (95% CI) were estimated by multinomial logistic regression. Results After applying the exclusion criteria, 980 (98.8%) individuals were included in the study. Of these, 621 (63.4%) had successful treatment, 163 (16.6%) lost to follow-up, 76 (7.8%) failed, and 120 (12.2%) died. Important factors associated with lost to follow-up in the final model included use of illicit drugs (OR = 2.5 95% CI: 1.57–3.82). Outcome failure was associated with having disease in both lungs (OR = 2.0; 95% CI: 1.09–3.62) and using more than one or not using injectable medication (OR = 2.8; 95% CI: 1.05–7.69). Major factors for the death outcome were at least 60 years old (OR = 3.4; 95% CI: 1.90–6.03) and HIV positive (OR = 2.7; 95% CI: 1.45–4.83). Conclusions The factors associated with unfavorable treatment outcomes were different. Some of these factors are specific to each outcome, which reflects the complexity of providing care to these individuals.

scholarly journals The impact of hypertension and use of calcium channel blockers on tuberculosis treatment outcomes

2020 ◽  
Author(s):  
Vignesh Chidambaram ◽  
Akshay Gupte ◽  
Jann-Yuan Wang ◽  
Jonathan Golub ◽  
Petros Karakousis
Keyword(s):  
Calcium Channel ◽  
Treatment Outcomes ◽  
Calcium Channel Blockers ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Channel Blockers ◽  
Tb Treatment ◽  
All Cause Mortality ◽  
The Impact ◽  
Related Mortality

Background: Hypertension induces systemic inflammation, but its impact on the outcome of infectious diseases like tuberculosis (TB) is unknown. Calcium channel blockers (CCB) improve TB treatment outcomes in pre-clinical models, but their effect in patients with TB remain unclear. Methods: This retrospective cohort study, including all patients > 18 years receiving treatment for culture-confirmed, drug-sensitive TB from 2000 to 2016 at the National Taiwan University Hospital, assessed the association of hypertension and CCB use with all-cause and infection-related mortality during the first 9 months of TB treatment, as well as sputum-smear microscopy and sputum-culture positivity at 2 and 6 months. Results: 1052 of the 2894 patients (36.4%) had hypertension. Multivariable analysis revealed that hypertension was associated with increased mortality due to all causes (HR 1.57, 95% confidence interval[CI], 1.23-1.99) and infections (HR 1.87, 95%CI, 1.34-2.6), but there was no statistical difference in microbiological outcomes when stratified based on hypertensive group. Dihydropyridine-CCB (DHP-CCB) use was associated with reduced all-cause mortality (HR 0.67, 95%CI: 0.45-0.98) only by univariate Cox regression. There was no association between DHP-CCB use and infection-related mortality (HR 0.78, 95%CI: 0.46-1.34) or microbiological outcomes in univariate or multivariate regression analyses. Conclusions: Patients with hypertension have increased all-cause mortality and infection-related mortality during the 9 months following TB treatment initiation. DHP-CCB use may lower all-cause mortality in TB patients with hypertension. The presence of hypertension or the use of CCB did not result in a significant change in microbiological outcomes. Keywords: Tuberculosis, hypertension, calcium channel blockers, mortality, treatment outcomes

scholarly journals Catastrophic costs due to tuberculosis worsen treatment outcomes: a prospective cohort study in Indonesia

2020 ◽  
Vol 114 (9) ◽  
pp. 666-673
Author(s):  
Ahmad Fuady ◽  
Tanja A J Houweling ◽  
Muchtaruddin Mansyur ◽  
Erlina Burhan ◽  
Jan Hendrik Richardus
Keyword(s):  
Treatment Outcomes ◽  
Treatment Adherence ◽  
Mixed Models ◽  
Multivariable Analysis ◽  
Annual Household Income ◽  
Rural Districts ◽  
Tb Treatment ◽  
Unsuccessful Treatment ◽  
One Year

Abstract Background While the incidence of catastrophic costs due to tuberculosis (TB) remains high, there is little evidence about their impact on TB treatment outcomes and adherence. We assessed their effect on treatment outcomes and adherence in Indonesia. Methods We interviewed 282 adult TB patients who underwent TB treatment in urban, suburban and rural districts of Indonesia. One year after the interview, we followed up treatment adherence and outcomes. We applied multivariable analysis using generalized linear mixed models. Results Follow-up was complete for 252/282 patients. Eighteen (7%) patients had unsuccessful treatment and 40 (16%) had poor adherence. At a threshold of 30% of annual household income, catastrophic costs negatively impacted treatment outcomes (adjusted odds ratio [aOR] 4.15 [95% confidence interval {CI} 1.15 to 15.01]). At other thresholds, the associations showed a similar pattern but were not statistically significant. The association between catastrophic costs and treatment adherence is complex because of reverse causation. After adjustment, catastrophic costs negatively affected treatment adherence at the 10% and 15% thresholds (aOR 2.11 [95% CI 0.97 to 4.59], p = 0.059 and aOR 2.06 [95% CI 0.95 to 4.46], p = 0.07). There was no evidence of such an effect at other thresholds. Conclusions Catastrophic costs negatively affect TB treatment outcomes and treatment adherence. To eliminate TB, it is essential to mitigate catastrophic costs.

scholarly journals Impact of Plasma Potassium Normalization on Short‐Term Mortality in Patients With Hypertension and Hyperkalemia

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Maria Lukács Krogager ◽  
Peter Søgaard ◽  
Christian Torp‐Pedersen ◽  
Henrik Bøggild ◽  
Gunnar Gislason ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Reference Group ◽  
Multivariable Analysis ◽  
Plasma Potassium ◽  
Cardiovascular Death ◽  
Risk Of Death ◽  
Increased Risk ◽  
Short Term Mortality

Background Hyperkalemia can be harmful, but the effect of correcting hyperkalemia is sparsely studied. We used nationwide data to examine hyperkalemia follow‐up in patients with hypertension. Methods and Results We identified 7620 patients with hypertension, who had the first plasma potassium measurement ≥4.7 mmol/L (hyperkalemia) within 100 days of combination antihypertensive therapy initiation. A second potassium was measured 6 to 100 days after the episode of hyperkalemia. All‐cause mortality within 90 days of the second potassium measurement was assessed using Cox regression. Mortality was examined for 8 predefined potassium intervals derived from the second measurement: 2.2 to 2.9 mmol/L (n=37), 3.0 to 3.4 mmol/L (n=184), 3.5 to 3.7 mmol/L (n=325), 3.8 to 4.0 mmol/L (n=791), 4.1 to 4.6 mmol/L (n=3533, reference), 4.7 to 5.0 mmol/L (n=1786), 5.1 to 5.5 mmol/L (n=720), and 5.6 to 7.8 mmol/L (n=244). Ninety‐day mortality in the 8 strata was 37.8%, 21.2%, 14.5%, 9.6%, 6.3%, 6.2%, 10.0%, and 16.4%, respectively. The multivariable analysis showed that patients with concentrations >5.5 mmol/L after an episode of hyperkalemia had increased mortality risk compared with the reference (hazard ratio [HR], 2.27; 95% CI, 1.60–3.20; P <0.001). Potassium intervals 3.5 to 3.7 mmol/L and 3.8 to 4.0 mmol/L were also associated with increased risk of death (HR, 1.71; 95% CI, 1.23–2.37; P <0.001; HR, 1.36; 95% CI, 1.04–1.76; P <0.001, respectively) compared with the reference group. We observed a trend toward increased risk of death within the interval 5.1 to 5.5 mmol/L (HR, 1.29; 95% CI, 0.98–1.69). Potassium concentrations <4.1 mmol/L and >5.0 mmol/L were associated with increased risk of cardiovascular death. Conclusions Overcorrection of hyperkalemia to levels <4.1 mmol/L was frequent and associated with increased all‐cause and cardiovascular mortality. Potassium concentrations >5.5 mmol/L were also associated with an increased all‐cause and cardiovascular mortality.

scholarly journals Factors associated with unfavourable treatment outcomes among people with rifampicin-resistant tuberculosis in Armenia, 2014-2017

2021 ◽  
Vol 91 (1) ◽  
Author(s):  
Lilit Khachatryan ◽  
Ruzanna Grigoryan ◽  
Andrei Dadu ◽  
Ajay M.V. Kumar ◽  
Kristina Akopyan ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
New Drugs ◽  
Health Concern ◽  
Factors Associated ◽  
Resistant Tuberculosis ◽  
Home Based ◽  
Mdr Tb

Rifampicin-Resistant/Multidrug-Resistant Tuberculosis (RR/MDR-TB) is recognized as a major public health concern globally. In Armenia, the proportion of RR/MDR-TB is increasing among all people affected with TB. We conducted a nationwide cohort study involving analysis of programmatic data to investigate the rates of and factors associated with unfavourable treatment outcomes among patients with RR/MDR-TB registered by the national TB programme from 2014 to 2017 in Armenia. We used Cox regression to identify factors associated with the outcome. Among 451 RR/MDR-TB patients, 80% were men and median age was 46 years. Of them, 53 (11.8%) had Extensively Drug-Resistant Tuberculosis (XDR-TB) and 132 (29.3%) had pre-XDR-TB. Almost half (224, 49.7%) of the patients had unfavourable treatment outcome, which included 26.8% Loss To Follow-Up (LTFU), 13.3% failures and 9.5% deaths. In multivariable analysis, people with pre-XDR-TB [adjusted Hazard Ratio [aHR] 3.13, 95% confidence intervals [CI] 2.16-4.55] and XDR-TB (aHR 4.08, 95% CI 2.45-6.79) had a higher risk of unfavourable outcomes. Patients receiving home-based treatment (71/451, 15.7%) and treatment with new drugs (172/451, 38.1%) had significantly lower risk (aHR 0.45, 95% CI 0.28-0.72 and aHR 0.26, 95% CI 0.18-0.39) of unfavourable treatment outcome.  The proportion of MDR-TB patients reaching favourable treatment outcome in Armenia was substantially lower than the recommended level (75%). The most common treatment outcome was LTFU indicating the need for further assessment of underlying determinants. Home-based treatment looks promising and future studies are required to see if expanding it to all RR/MDR-TB patients is feasible and cost-effective.

Factors Associated with Unsuccessful Outcomes of Tuberculosis Treatment in 125 Municipalities in Colombia 2014 to 2016

2021 ◽  
Author(s):  
Lizeth Andrea Paniagua-Saldarriaga ◽  
Daniele Maria Pelissari ◽  
Zulma Vanessa Rueda
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Treatment Success ◽  
Tuberculosis Treatment ◽  
People Living With Hiv ◽  
Surveillance Systems ◽  
Factors Associated ◽  
Tb Treatment ◽  
Lost To Follow Up

Our aim was to identify the risk factors associated with unsuccessful outcomes of tuberculosis (TB) treatment in patients diagnosed between 2014 and 2016 in the 125 municipalities of Antioquia, Colombia. We studied a retrospective cohort of patients with TB diagnosed between 2014 and 2016, from national routine surveillance systems, in 125 municipalities of Antioquia. Factors associated with unsuccessful tuberculosis treatment outcomes (treatment failed, lost to follow up, or death) were identified utilizing a Poisson regression with robust variance. Over 3 years, of the 6,739 drug-susceptible tuberculosis patients, 73.4% had successful treatment and 26.6% unsuccessful outcomes (17% lost to follow up, 8.9% deaths, and 0.7% treatment failures). Patients with subsidized health insurance (Relative risk [RR]: 2.4; 95% CI: 2.1–2.8) and without health insurance (RR: 2.5; 95% CI: 2.1–3.0) had a higher risk for unsuccessful tuberculosis treatment compared to those with contributive health insurance. Other risk factors included age over 15 years, male sex, homelessness, people living with HIV, previous treatment, and primary diagnosis during hospitalization. Protective factors were living in a rural area and extrapulmonary disease. It is important to generate strategies that improves tuberculosis diagnosis in primary healthcare institutions. In addition, it is imperative to initiate new research about the barriers and obstacles related to patients, healthcare workers and services, and the health system, including the analysis of urban violence, to understand why the goal of TB treatment success has not been reached.

scholarly journals Treatment Outcome of Tuberculosis and Associated Factors among TB-HIV Co-Infected Patients at Public Hospitals of Harar Town, Eastern Ethiopia. A five-year retrospective study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Assefa Tola ◽  
Kirubel Minsamo Mishore ◽  
Yohanes Ayele ◽  
Abraham Nigussie Mekuria ◽  
Nanati Legese
Keyword(s):  
Treatment Outcome ◽  
Retrospective Study ◽  
Treatment Outcomes ◽  
Associated Factors ◽  
Public Hospitals ◽  
Tb Treatment ◽  
Poor Treatment ◽  
History Of ◽  
Lost To Follow Up

Abstract Background The bidirectional relationship between the twin epidemics of Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) causes major global health challenges in the twenty-first century. TB-HIV co-infected people are facing multifaceted problems like high lost to follow up rates, poor treatment adherence, high TB recurrence rate, and high mortality risk. Our objective was to assess the outcomes of TB treatment and associated factors among TB-HIV co-infected patients in Harar town, Eastern part of Ethiopia, 2018. Methods A retrospective study was conducted among systematically selected 349 TB/HIV co-infected patients who registered from 2012 to 2017 in two public hospitals in Harar town. The data were collected through document review by using a pre-tested structured data extraction checklist. The data were analyzed using SPSS Version 21. Bivariate and multivariate logistic regression were determined at 95% confidence intervals. Results Among the 349 TB/HIV co-infected patients included in the study, 30.1% were cured, 56.7% had completed their treatment, 7.7% died, 1.7% were lost to follow up, and 3.7% were treatment failure. Overall, 86.8% of the TB-HIV co-infected patients had successful TB treatment outcomes. The patients who were on re-treatment category (AOR = 2.91, 95% CI: 1.17–7.28), who had a history of opportunistic infection (AOR = 3.68, 95% CI: 1.62–8.33), and who did not take co-trimoxazole prophylaxis (AOR = 3.54, 95% CI: 1.59–7.89) had 2.91, 3.68, and 3.54 times higher odds of having unsuccessful TB treatment outcome than their counterparties, respectively. The chance of unsuccessful TB treatment outcome was 4.46 (95% CI: 1.24–16.02), 5.94 (95% CI: 1.87–18.85), and 3.01 (95% CI: 1.15–7.91) times higher among TB/HIV patients in stage 2, 3 and 4 than those in stage 1, respectively. Conclusions The overall rate of the success of the TB treatment among TB-HIV co-infected patients in this study was higher compared with many previous studies. TB/HIV patients with a history of previous TB treatment, smear-positive pulmonary TB, late HIV stage, history of opportunistic infection and not being on co-trimoxazole prophylaxis therapy were at a high risk of getting poor treatment outcomes.

scholarly journals Urban-rural disparities in treatment outcomes among recurrent TB cases in Southern Province, Zambia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Simon Mutembo ◽  
Jane N. Mutanga ◽  
Kebby Musokotwane ◽  
Cuthbert Kanene ◽  
Kevin Dobbin ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Rural Areas ◽  
Directly Observed Therapy ◽  
Public Health Importance ◽  
Southern Province ◽  
Risk Of Death ◽  
Therapy Strategy ◽  
Rural Settings ◽  
Lost To Follow Up

Abstract Background At least 13–20% of all Tuberculosis (TB) cases are recurrent TB. Recurrent TB has critical public health importance because recurrent TB patients have high risk of Multi-Drug Resistant TB (MDR-TB). It is critical to understand variations in the prevalence and treatment outcomes of recurrent TB between different geographical settings. The objective of our study was to estimate the prevalence of recurrent TB among TB cases and compare risk of unfavorable treatment outcomes between rural and urban settings. Methods In a retrospective cohort study conducted in southern province of Zambia, we used mixed effects logistic regression to asses associations between explanatory and outcome variables. Primary outcome was all-cause mortality and exposure was setting (rural/urban). Data was abstracted from the facility TB registers. Results Overall 3566 recurrent TB cases were diagnosed among 25,533 TB patients. The prevalence of recurrent TB was 15.3% (95% CI: 14.8 15.9) in urban and 11.3% (95% CI: 10.7 12.0) in rural areas. Death occurred in 197 (5.5%), 103 (2.9%) were lost to follow-up, and 113 (3.2%) failed treatment. Rural settings had 70% higher risk of death (adjusted OR: 1.7; 95% CI: 1.2 2.7). Risk of lost to follow-up was twice higher in rural than urban (adjusted OR: 2.0 95% CI: 1.3 3.0). Compared to HIV-uninfected, HIV-infected individuals on Antiretroviral Treatment (ART) were 70% more likely to die (adjusted OR: 1.7; 95% CI: 1.2 3.1). Conclusion Recurrent TB prevalence was generally high in both urban and rural settings. The risk of mortality and lost to follow-up was higher among rural patients. We recommend a well-organized Directly Observed Therapy strategy adapted to setting where heightened TB control activities are focused on areas with poor treatment outcomes.

scholarly journals Epidemiology and factors of tuberculosis treatment outcome, Bangladesh, 2012-13

2021 ◽  
Vol 9 (1) ◽  
pp. 100
Author(s):  
Rabeya Sultana ◽  
Mojibur Rahman ◽  
Mahmudur Rahman
Keyword(s):  
Treatment Outcome ◽  
Multivariable Analysis ◽  
Outcome Data ◽  
Male Gender ◽  
Important Indicator ◽  
Tb Treatment ◽  
Chest Disease ◽  
Disease Hospital ◽  
Lost To Follow Up

Tuberculosis (TB) treatment outcome is an important indicator to improve TB control efforts. We assessed factors associated with unfavorable treatment outcomes among smear-positive pulmonary TB patients reported to the national TB program from January 2012 to December 2013 in Bangladesh. Favorable outcomes were cured and treatment completed with unfavorable outcomes as failed, defaulted, died and lost to follow-up. We retrieved 98,932 patients with outcome data; 65,458 (66%) were male and 7,956 (8%) had unfavorable outcomes (3,737 (47%) died, 1,641 (21%) defaulted, and 1,599 (20%) lost to follow-up). In multivariable analysis, male gender (adjusted odds ratio [aOR] 1.41; 95% confidence interval [CI] 1.34-1.49) and treatment at a chest disease hospital (CDH) (aOR 1.44; 95% CI 1.25-1.66) were risk factors. The association between male gender and unfavorable outcomes may result from the high smoking rates among males in Bangladesh. The association of treatment at a CDH with unfavorable outcomes may occur because complicated cases (e.g., TB with co-infections) are usually treated in a chest hospital in Bangladesh. A case-control study could further confirm and explain these findings.

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