Evaluating tuberculosis treatment outcomes in Haiti from 2018 to 2019: A competing risk analysis

Abstract

ObjectivesThis study assesses tuberculosis (TB) treatment outcomes in Haiti. MethodsData from drug-susceptible patients with TB (2018-2019) were analyzed using the Fine & Gray model with multiple imputation. ResultsOf the 16,545 patients, 14.7% had concurrent HIV coinfection, with a 66.2% success rate. The median treatment duration was 5 months, with patients averaging 30 years (with an interquartile range of 22-42 years). The estimated hazard of achieving a successful treatment outcome decreased by 2.5% and 8.1% for patients aged 45 and 60 years, respectively, compared with patients aged 30 years. Male patients had a 6.5% lower estimated hazard of success than their female counterparts. In addition, patients coinfected with HIV experienced a 35.3% reduction in the estimated hazard of achieving a successful treatment outcome compared with those with a negative HIV serologic status. ConclusionsIntegrated health care approaches should be implemented, incorporating innovative solutions, such as machine learning algorithms combined with geographic information systems and non-conventional data sources (including social media), to identify TB hotspots and high-burden households.