Abstract
BackgroundUnderstanding the explanations behind unsuccessful treatment outcomes in tuberculosis (TB) patients is important to improve treatment success. Treatment completion for TB is the mainstay of TB prevention and control. The study was aimed to assess the treatment outcomes and predictors for unsuccessful outcomes among children with TB.MethodsThis was a prospective multicenter study conducted in Sindh. Children aged ≤14 years enrolled from June to November 2016 were included. A structured data collection tool was used to gather information with respect to patients’ socio-demographic, clinical and microbiological data. Additionally, to collect the information related to socio-economic and education level of caregivers, validated questionnaire was administered to the caregivers. Treatment outcomes were assessed according to the World Health Organization (WHO) guidelines. The relationship of unsuccessful treatment outcome with socio-demographic and clinical attributes of TB patients was analyzed using logistic regression model.ResultsChildhood TB represented 19.3% (508/2634) of all TB cases in selected hospitals. Of these, 268/508 (52.8%) were females and one third of the children were aged ≤2 years (34.3%). In multivariate analysis, pulmonary smear positive TB (PTB+) (AOR = 5.910, 95%CI = 1.64–21.29), those with adverse drug reactions (AOR = 11.601, 95%CI = 4.06–33.12) and those who had known TB contacts (AOR = 3.128, 95%CI = 1.21–8.06) showed statistically significant association with unsuccessful treatment outcomes.ConclusionsThe high proportion of childhood TB cases (19.3%) demonstrates the continuation of TB transmission in the study setting. Furthermore, an increased focus on PTB+ patients, those with adverse drug reactions and household contact with TB is warranted.
Highlights
Understanding the explanations behind unsuccessful treatment outcomes in tuberculosis (TB) patients is important to improve treatment success
There is Laghari et al BMC Infectious Diseases (2019) 19:82 evidence that in these settings most of the TB cases were being missed in large hospitals in Tertiary Care Hospitals where most of the presumptive TB cases go unrecognized, the diagnosed and treated cases are not reported to the National Tuberculosis Control Programme (NTP) or the treatment may not follow national guidelines [5]
Examining and assessment of treatment outcomes of TB patients is an essential element of the Directly Observed Therapy Short (DOTS) strategy [7]
Summary
Understanding the explanations behind unsuccessful treatment outcomes in tuberculosis (TB) patients is important to improve treatment success. There is Laghari et al BMC Infectious Diseases (2019) 19:82 evidence that in these settings most of the TB cases were being missed in large hospitals in Tertiary Care Hospitals where most of the presumptive TB cases go unrecognized, the diagnosed and treated cases are not reported to the NTP or the treatment may not follow national guidelines [5]. In 2015, the treatment success rate in new and relapse cases in Pakistan was reported as 93% [4]. Treatment outcome at the end of therapy is an important marker of TB control programmes [6]. Examining and assessment of treatment outcomes of TB patients is an essential element of the DOTS strategy [7]
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