Factors associated with pulmonary tuberculosis treatment failure in Togo, 2015-2016

Abstract

Tuberculosis (TB) treatment failure compromises its elimination as recommended by Sustainable Development Goals. The purpose of this study is to determine the factors associated with pulmonary TB treatment failure in Togo between 2015 and 2016. An unmatched case-control study was conducted on cases of pulmonary TB under treatment at all of 47 TB Diagnostic and Treatment Centers (DTC) in Togo between 2015 and 2016. Treatment failure of TB was defined as any patient whose sputum smear or culture was positive at the fifth month or later during treatment. Controls were patients whose smear sputum was negative at the fifth month of treatment or later. Logistic regression model was performed to identify independently associated factors by calculating Adjusted Odds Ratio (AOR). In multivariate analysis, factors associated with treatment failure were: Positive sputum result in second month (AOR = 38.75; 95% CI [10.52-142.76], p≤0.001), occurrence of side effects [AOR=3, 61; 95% CI (1.06-12.22), p=0.038], treatment interruption for at least 14 days [AOR=8.15; 95% CI (2.35-28.28), p≤0.001], absence of family-based Directly Observed Treatment practice (AOR=23.76; 95% CI [5.66-99.64], p≤0.001). The study identified the socio-demographic and clinical factors of TB treatment failure whose inclusion in action plans would contribute to achieve TB elimination in Togo. Key words: Tuberculosis, treatment failure, directly observed treatment short-course, Togo.