Increased meat consumption is associated with reduced tuberculosis treatment failure rate: A cohort study.

Tuberculosis (TB) treatment success rates are high in China, but there are still a considerable number of cases who have unfavourable treatment outcomes (UTO). We aimed to determine the proportion of TB patients with UTO and to assess whether baseline characteristics that included glycaemic status [normal fasting blood glucose (FBG), transient hyperglycaemia and diabetes mellitus (DM)] and vitamin D status were associated with UTO. Prospective cohort study conducted between November 2015 and July 2016 at six clinics within routine TB services in Jilin province, where persons with TB were consecutively recruited. Data analysis was performed using the chi-squared test and multivariate logistic regression. Of the306 recruited TB patients, 96 (31.4%) had smear-positive pulmonary TB, 187 (61.1%) had smear-negative pulmonary TB and 23 (7.5%) had extrapulmonary TB (EPTB). Of these, 95 (31.1%) had normal blood glucose, 83 (27.1%) had transient hyperglycaemia and 128 (41.8%) had DM. 227 (74.2%) patients had vitamin D deficiency/severe deficiency. There were 125 (40.8%) patients with UTO of whom the majority were lost to follow-up (57.6%) or not evaluated (28.8%). UTO was significantly associated with smear-negative pulmonary TB (P=0.009), EPTB (P<0.001) and DM (P=0.007). The proportion of TB patients with UTO increased with smear-negative pulmonary TB, EPTB and DM. TB programmes need to pay more attention to these issues and ensure intensive patient support to those at risk and early detection of DM.

BackgroundData regarding tuberculosis (TB) treatment outcomes, proportion of TB/HIV co-infection and associated factors have been released at different TB treatment facilities in Ethiopia and elsewhere in the world as part of the auditing and surveillance service. However, these data are missing for the TB clinic offering directly observed treatment short-course (DOTs) at Debre Tabor General Hospital (DTGH).MethodsThe authors analysed the records of 985 TB patients registered at the DTGH from September 2008 to December 2016. Data on patients’ sex, age, type of TB, and treatment outcomes were extracted from the TB treatment registration logbook. The treatment outcome of patients was categorized according to the National TB and Leprosy Control Program guidelines: cured, treatment completed, treatment failed, died, and not evaluated (transferred out and unknown cases).ResultsAround half of the registered patients were males (516, 52.4%). In terms of TB types, 381 (38.7%), 241 (24.5%), and 363 (36.9%) patients had smear-negative pulmonary TB, smear-positive pulmonary TB, and extra pulmonary TB, respectively. Six hundred and seventy-two patients (90.1%) had successful treatment outcomes (cured and treatment completed), while 74 patients (9.9%) had unsuccessful treatment outcomes (death and treatment failure).TB treatment outcome was not associated with age, sex, type and history of TB, or co-infection with HIV (P > 0.05). The proportion of TB/HIV co-infection was at 24.2%, and these were found to be significantly associated with the age groups of 25–34, 35–44 and ≥65 years:(aOR: 0.44; 95% CI: 0.25–0.8), (aOR: 0.39; 95% CI: 0.20–0.70), (aOR: 4.2; 95% CI: 1.30–12.9), respectively.ConclusionsThe proportion of patients with successful treatment outcomes was above the World Health Organization target set for Millennium Development Goal of 85% and in line with that of the global milestone target set at > 90% for 2025. Relatively higher proportions of transfer-out cases were recorded in the present study. Similarly, the proportion of TB/HIV co-infection cases was much higher than the national average of 8%.Thus, the health facility under study should develop strategies to record the final treatment outcome of transfer-out cases. In addition, strategies to reduce the burden of TB/HIV co-infection should be strengthened.

Excerpt No drug having been thus far found in the treatment of tuberculosis which kills all tubercle bacilli, the objectives of drug treatment in this disease still fall short of the eradication of...

Article1 July 1953ANTIMICROBIAL THERAPY OF PULMONARY TUBERCULOSIS: REVIEW OF SIX YEARS' EXPERIENCE AT FITZSIMONS ARMY HOSPITALCARL W. TEMPEL, FORREST W. PITTS, WILLIAM E. DYECARL W. TEMPELSearch for more papers by this author, FORREST W. PITTSSearch for more papers by this author, WILLIAM E. DYESearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-39-1-61 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSix antimicrobial agents have been subjected to a methodical pattern of clinical investigation since 1946 at Fitzsimons Army Hospital. Approximately 1,300 patients have been evaluated under controlled conditions employing streptomycin, para-aminosalicylic acid, amithiozone, viomycin, terramycin and Isoniazid, either singly or in various combinations.1 Therapeutic efficacy, bacteriologic cultural and resistance studies, and toxicity formed the principal criteria for evaluating these drug regimens. Summary data on 875 patients observed on the research wards constitute the basis of this report.Studies were performed on a homogeneous group of patients relative to extent and clinical pathologic type of disease. Almost all were young adult...Bibliography1. Tempel CW: Present status of specific drug treatment of tuberculosis, J. A. M. A. 150: 1165-1170 (Nov. 22) 1952. CrossrefMedlineGoogle Scholar2. TempelHughesMardisTowbinDye CWFJREMNWE: Combined intermittent regimens employing streptomycin and para-aminosalicylic acid in the treatment of pulmonary tuberculosis, Transactions of the Ninth Streptomycin Conference (VA), 36-50 (Apr.) 1950. Google Scholar3. TempelHughesMardisTowbinDye CWFJREMNWE: Combined intermittent regimens employing streptomycin and para-aminosalicylic acid in the treatment of pulmonary tuberculosis; a comparison with daily and intermittent dosage schedules, Am. Rev. Tuberc. 63: 295-311 (Mar.) 1951. MedlineGoogle Scholar4. HughesMardisDyeTempel FJREWECW: Combined intermittent regimens in the treatment of pulmonary tuberculosis, Transactions of the 10th Conference on the Chemotherapy of Tuberculosis (VA), 67-76 (Jan.) 1951. Google Scholar5. HughesMardisDyeTempel FJREWECW: Combined intermittent regimens in the treatment of non-miliary pulmonary tuberculosis; a comparison of streptomycin every third day and para-aminosalicylic acid daily with streptomycin every third day and para-aminosalicylic acid every third day, Dis. Chest 21: 1-16 (Jan.) 1952. CrossrefMedlineGoogle Scholar6. D'EsopoRaleigh NDMD: Further experience with prolonged chemotherapy, Transactions of the Ninth Streptomycin Conference (VA), 56-66 (Apr.) 1950. Google Scholar7. O'DellPittsRowanDyeHughes ETFWAIWEFJ: The administration of amithiozone alone and in combination with intermittent streptomycin in non-miliary pulmonary tuberculosis, Transactions of the Eleventh Conference on Chemotherapy of Tuberculosis (VA), 332-337 (Jan.) 1952. Google Scholar8. PittsO'DellDyeHughesTempel FWETWEFJCW: Intermittent viomycin therapy in pulmonary tuberculosis; a preliminary report, Transactions of the Eleventh Conference on Chemotherapy of Tuberculosis (VA), 270-285 (Jan.) 1952. Google Scholar9. PittsO'DellDyeHughesTempel FWETWEFJCW: Intermittent viomycin therapy in pulmonary tuberculosis, Dis. Chest 23: 241-255 (March) 1953. CrossrefMedlineGoogle Scholar10. MillerSandsWalkerDyeTempel FLJHRWECW: Combined daily terramycin and intermittent streptomycin in the treatment of pulmonary tuberculosis; a preliminary report, Transactions of the Eleventh Conference on Chemotherapy of Tuberculosis (VA), 53-59 (Jan.) 1952. Google Scholar11. MillerSandsWalkerDyeTempel FLJHRWECW: Combined daily terramycin and intermittent streptomycin in the treatment of pulmonary tuberculosis, Am. Rev. Tuberc. 66: 534 (Nov.) 1952. MedlineGoogle Scholar12. PittsMillerDyeTempelFitzpatrick FWFLWECWMJ: Isoniazid therapy in pulmonary tuberculosis, U. S. Armed Forces M. J. 4: 1 (Jan.) 1953. MedlineGoogle Scholar13. PittsTempelMillerSandsFitzpatrickWeiser FWCWFLJHMJO: Isoniazid-streptomycin in the treatment of pulmonary tuberculosis: a preliminary report, J. A. M. A., in press. Google Scholar14. Pinner M: Pulmonary tuberculosis in the adult, 1945, Charles C. Thomas, Springfield, Illinois, p. 299. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Read before the 119th Meeting of the American Association for the Advancement of Science, December 26, 1952, St. Louis, Missouri. Received for publication March 3, 1953.From the Medical Service and Research and Development Branch, Fitzsimons Army Hospital, Denver, Colorado. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTrends in the Management of Pulmonary TuberculosisLONG-TERM OXYTETRACYCLINE (TERRAMYCIN) THERAPY IN ADVANCED CHRONIC RESPIRATORY INFECTIONSCurrent Concepts in the Treatment of Pulmonary TuberculosisATYPICAL TUBERCULOSIS OF THE LIVER WITH JAUNDICE*EDWARD A. CLEVE, JOHN R. GIBSON, WILLIAM M. WEBB 1 July 1953Volume 39, Issue 1Page: 61-73KeywordsAdverse reactionsAntimicrobialsHealth services researchIsoniazidMedical servicesStreptomycinToxicityYoung adults ePublished: 1 December 2008 Issue Published: 1 July 1953 PDF downloadLoading ...

In low-resource countries like Somalia, tuberculosis (TB) is still a serious global health concern. Understanding the treatment outcomes of TB patients in specific regions is crucial for developing effective strategies to combat the disease. This study aimed to assess the treatment outcomes of TB patients in Benadir, Somalia. A retrospective cohort study was conducted using data from TB treatment centers in Benadir, Somalia. The study included all TB patients who initiated treatment between July 1, 2019 and June 30, 2020. Treatment outcomes, including treatment success, treatment failure, lost, death, and transfer out, were analyzed. Factors associated with treatment outcomes were also examined using chi-square test. The study comprised 3165 TB patients in total. The mean age of the observations was 29.9 years, with males making up the majority (64.58%). The overall success rate of TB treatment was 80.6%, with 5.3% lost, 4.6% died, 0.5% failed, 4.6% transferred out, and 4.4% not evaluated. Factors associated with unfavorable treatment outcomes included older age and HIV co-infection. The treatment success rate for TB patients in Benadir, Somalia, is below the global target of 90%. Enhancing access to quality TB diagnostic and treatment services, as well as addressing social and economic barriers to treatment adherence, are essential for improving TB control in Benadir, Somalia.

Excerpt The therapy of tuberculosis has undergone a remarkable change since the advent of antimicrobials, particularly isoniazid. Cornerstones of past treatment have in many instances been relegate...

Background: In Benin, little is known about the influence of both gender and HIV-status on diagnostic patterns and treatment outcomes of Tuber-culosis (TB) patients. Objective: To assess whether differences in gender and HIV status affect diagnostic patterns and treatment outcomes of TB patients. Methods: Retrospective cohort study of patients registered in 2013 and 2014 in the three largest TB Basic Management Units in south Benin. Results: Of 2694 registered TB patients, 1700 (63.1%) were male. Case notification rates were higher in males compared with females (96 vs 53/100,000 inhabitants). The male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV negative cases. In HIV-positive patients, there were no differences in TB types between men and women. In HIV-negative patients, there were significantly higher proportions of females with clinically diagnosed pulmonary TB (p = 0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times higher amongst males compared with females. For New bacteriologically confirmed pulmonary TB, no differences were observed in treatment outcomes between genders in the HIV positive group; but significantly more unfavorable outcomes were reported among HIV negative males, with higher rates of failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study has shown that overall TB notification rates were higher in males than in females in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.

BackgroundDrug resistant tuberculosis is a major public health problem in Morocco and worldwide. Treatment outcome of drug resistant tuberculosis is poor and requires a long period of treatment with many toxic and expensive antituberculosis drugs. The aim of this study is to evaluate treatment outcomes of drug resistant tuberculosis and to determine predictors of poor treatment outcomes in a large region of Morocco.MethodsIt is a multi-centric observational cohort study conducted from January 01, 2014 to January 01, 2016. A questionnaire was established to collect data from clinical charts of patients with confirmed resistant TB. The study was carried out in all the 11 centers located in the Rabat-Salé-Kénitra region of Morocco where drug resistant tuberculosis is treated. Treatment outcomes were reported and the definitions and classifications of these outcomes were defined according to the WHO guidelines. Univariate and multivariate logistic regression were conducted to determine factors associated with poor drug resistant tuberculosis treatment outcomes in Morocco.ResultsIn our study, 101 patients were treated for drug resistant tuberculosis between January 01, 2014 and January 01, 2016. Patients’ age ranged from 9.5 to70 years; 72patients (71.3%) were male and 80 patients (79.2%) were living in urban areas. Thirty two patients were smokers, 74 patients had multidrug-resistant tuberculosis, 25 patients had rifampicin resistance and 2 patients had isoniazid resistance. Treatment outcomes of tuberculosis patients were as follows: 45 patients were cured (44.5%), 9 completed treatment (8.9%), 5 patients died before completing the treatment, 35 patients were lost to follow up (34.6%) and 7 patients had treatment failure. In the multivariate analysis, being a smoker is an independent risk factor for poor treatment outcomes, (p-value = 0.015, OR = 4.355, IC [1.327–14.292]).ConclusionTreatment success outcomes occurred in more than half of the cases, which is lower than the World Health Organization target of at least a 75% success rate. A significant number of patients abandoned their treatment before its completion. These dropouts are a serious public health hazard that needs to be addressed urgently.

BackgroundDiabetes mellitus (DM) affects tuberculosis (TB) treatment outcomes, mostly by increasing recurrence, mortality and treatment failure. The objectives were to determine the pattern of change in glycosylated haemoglobin (HbA1c) level in new TB patients admitted to hospital at the start and 3-months after TB treatment, and to relate the measurements at these two time intervals to whether patients successfully completed treatment.MethodsA prospective cohort study was conducted on hospitalized new TB patients at Masih Daneshvari Hospital from 2012 to 2013. All patients were tested for HbA1c at the beginning and 3 months after initiation of TB treatment. Changes in HbA1c were compared to TB treatment outcome.ResultsThere were 317 new TB cases admitted to hospital of which 158 had HbA1c at baseline and 3-months. Of these, 67 (42%) had normal values, 54 had an elevated HbA1c at either base-line or 3-months (uncertain diabetes status) and 37 (24%) had elevated HbA1c (≥6.5%) at both time points (DM). There were differences between the groups: those with DM were older, had a known history of DM and a higher prevalence of cavities on chest x-ray. There were 150 (95%) patients who successfully completed treatment with no significant differences between the groups.ConclusionThere were changes in HbA1c during the first three-months of anti-TB treatment, but these were not associated with differences in TB treatment outcomes. Transient hyperglycemia should be considered in TB patients and needs to be taken into account in planning care and management.

Background: Tuberculosis is an endemic infection in Iran. Despite improved living standards and availability of free drugs, tuberculosis remains a major health problem here. In this study, we have assessed the treatment outcome of tuberculosis patients. Materials and Methods: In this descriptive study, all new cases of pulmonary tuberculosis with a smear or culture that is positive, admitted in Nikopoor Referral Clinic, in Yazd, Iran, were studied. Results: Of the 280 patients, 148 (52.9%) were males and 132 (47.1%) were females. Among these patients 202 (72.2%) had pulmonary smear-positive tuberculosis and 78 (27.8%) patients had smear-negative pulmonary tuberculosis. The treatment outcome was, 247 (90.8%) had successful treatments, there were three (1.1%) treatment failures, 10 (3.7%) treatment defaulters, nine (3.3%) died, and three (1.1%) transferred to a different area. Conclusion: In our study, the cure rate among the new smear-positive patients was more than the rate recommended by the World Health Organization (WHO).

OBJECTIVES/SPECIFIC AIMS: Previous research suggests that weight loss during early TB treatment (first two months of anti-TB therapy) is a predictor of poor tuberculosis (TB) treatment outcomes among HIV-negative populations, but the relationship has not been well studied in the context of HIV. We examined the association between HIV and weight change during the first two months of anti-tuberculosis treatment, and also assessed the effects of HIV and early weight change on tuberculosis (TB) treatment outcomes. METHODS/STUDY POPULATION: Adults with culture-confirmed, drug-susceptible, pulmonary TB, regardless of HIV status, were enrolled into the Regional Prospective Observational Research for Tuberculosis (RePORT)-Brazil cohort and followed on standard anti-TB therapy. For the primary analysis, we compared weight change in persons living with HIV (PLWH) and HIV-negative patients between baseline and two months using multivariable bootstrapped quantile regression and modified Poisson regression. For secondary analysis, we examined the separate effects of HIV and weight change on poor TB treatment outcome (treatment failure, TB recurrence, or death) using Cox proportional hazards regression. RESULTS/ANTICIPATED RESULTS: Among 323 participants, 45 (14%) were HIV-positive. On average, PLWH lost 0.7% (interquartile range (IQR): −5.1%, 4.4%) of their baseline body weight between baseline and two months; those without HIV gained 3.5% (IQR: 0.8%, 6.7%). After adjusting for age, sex, and baseline BMI, PLWH lost 4.1% (95% confidence interval (CI): −6.5%, −1.6%) more weight during the first two months of anti-TB treatment than HIV-negative individuals. HIV infection was associated with weight loss ≥5% (adjusted odds ratio = 9.3; 95% CI: 4.2-20.6). Regarding the secondary analysis, 14 patients had a poor TB treatment outcome: 2 treatment failures, 4 cases of recurrent TB, and 8 deaths. PLWH and patients who lost ≥5% weight had significantly increased risk of poor TB treatment outcome with hazard ratios of 8.77 (95% CI: 2.96-25.94) and 4.09 (95% CI: 1.11-15.14), respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: Our results suggest that HIV is associated with weight loss during early TB treatment, and both HIV and early weight loss were associated with poor treatment outcome. Future research should examine the potential etiologies of these findings and identify the types of interventions that would best promote weight gain during TB treatment, especially among PLWH, in order to prevent poor TB treatment outcomes.

BackgroundXpert MTB/Rif (Xpert) is described as a game changer in tuberculosis (TB) control. We evaluated the impact of Xpert on diagnosis, time to treatment, and treatment outcome among patients with HIV associated TB in Nigeria.MethodsAdults with HIV being evaluated for pulmonary TB (PTB) were consecutively enrolled into the study cohort. At baseline, expectorated sputa were examined using Xpert and smear microscopy for Mycobacterium tuberculosis (MTB) and acid fast bacilli, respectively. Patients diagnosed with TB were followed-up until 6 months post TB diagnosis. TB was defined as sputum positive by smear microscopy, Xpert detection of MTB (bacteriologically confirmed case), or clinician diagnosed TB with initiation of full TB treatment (clinical diagnosis). Time to treatment was time from first clinic presentation for TB evaluation to initiation of TB treatment. We examined the proportion PTB patients with a positive Xpert result and compared time to TB treatment and outcome of TB treatment in patients based on sputum test results.ResultsA total of 310 adults with HIV were enrolled. The median CD4 cell count was 242 (interquartile range (IQR) 120–425) cells/mm3 and 88.1% were receiving antiretroviral therapy (ART). PTB was diagnosed in 76 (24.5%) patients, with 71 (93.4%) being bacteriologically confirmed. Among patients with PTB, 56 (73.7%) were Xpert positive. Median time to treatment was 5 (IQR 2–8) days and 12 (IQR 5–35) days in patient with and without Xpert positive results, respectively; p = 0.005. Overall 73.1% had symptom free survival at 6 months post PTB treatment initiation with no significant differences observed based on TB test method. 10 (14.9%) died within 6 months of TB treatment initiation. In analysis adjusted for age, sex, and mode of diagnosis (Xpert positive or negative), only ART use independently predicted mortality (AOR 0.10; 95% CI 0.01–0.93).ConclusionThe use of Xpert for routine care reduced time to PTB treatment, but did not improve survival in patients with HIV treated for susceptible PTB.

Background The rising prevalence of diabetes mellitus DM in countries with high burden of tuberculosis TB may adversely affect tuberculosis control. Revised National Tuberculosis Control Programme RNTPC prescribes the same treatment regimen for patients with tuberculosis and diabetes that is used for non-diabetics. Under the programme setting there is a need for study on successful treatment outcome of Tuberculosis patients with known Diabetes Mellitus.Objective To analyze the Tuberculosis treatment outcome in patients with known Diabetes Mellitus treated under RNTCP setting in an urban area.Methods After cluster sampling among the 9 Tuberculosis Units in Bangalore 5 were chosen randomly. 75 TB-DM patients and 150 TB without Diabetes were enrolled into the study and followed up for their treatment outcome.Results Of the 75 TB-DM patients 72 were males and 28 were females. gt90 of the patients were of age above 40 years. Overall treatment outcome was 81 and 87 among TB-DM and TB without DM respectively. It was not statistically significant Fishers exact test p0.3256.Conclusion RNTCPs DOTS regimen holds good for TB patients with and without Diabetes Mellitus. The DM co-morbidity did not significantly change the TB treatment outcome. Hence the current DOTS regime under RNTCPcan be applied to the TB-DM co-morbid patients.

Tuberculosis (TB) is one of the major public health and socio-economic issues in the 21st century globally. Assessment of TB treatment outcomes, and monitoring and evaluation of its risk factors in Directly Observed Treatment Short Course (DOTS) are among the major indicators of the performance of a national TB control program. Hence, this institution-based retrospective study was conducted to determine the treatment outcome of TB patients and investigate factors associated with unsuccessful outcome at Dilla University Referral Hospital, southern Ethiopia. Five years (2008 to 2013) TB record of TB clinic of the hospital was reviewed. A total 1537 registered TB patients with complete information were included. Of these, 942 (61.3%) were male, 1015 (66%) were from rural areas, 544 (35.4%) were smear positive pulmonary TB (PTB+), 816 (53.1%) were smear negative pulmonary TB (PTB-) and 177(11.5%) were extra pulmonary TB (EPTB) patients. Records of the 1537 TB patients showed that 181 (11.8%) were cured, 1129(73.5%) completed treatment, 171 (11.1%) defaulted, 52 (3.4%) died and 4 (0.3%) had treatment failure. The overall mean treatment success rate of the TB patients was 85.2%. The treatment success rate of the TB patients increased from 80.5% in September 2008-August 2009 to 84.8% in September 2012–May 2013. Tuberculosis type, age, residence and year of treatment were significantly associated with unsuccessful treatment outcome. The risk of unsuccessful outcome was significantly higher among TB patients from rural areas (AOR = 1.63, 95% CI: 1.21–2.20) compared to their urban counterparts. Unsuccessful treatment outcome was also observed in PTB- patients (AOR = 1.77, 95% CI: 1.26–2.50) and EPTB (AOR = 2.07, 95% CI: 1.28–3.37) compared to the PTB+ patients. In conclusion, it appears that DOTS have improved treatment success in the hospital during five years. Regular follow-up of patients with poor treatment outcome and provision of health information on TB treatment to patients from rural area is recommended.

Trends and outcomes of tuberculosis among cases on directly observed short course treatment (DOTS) at Tepi public health center Southwest Ethiopia