PRS8 - Impact of Illicit Drug Use On Treatment Outcomes Among Tuberculosis Patients

Abstract

Illicit drug use is an important epidemiological factor for assessment of poor treatment outcomes among tuberculosis patients. The aim of current study was to determine treatment outcomes of tuberculosis among drug abusers in Malaysia. A retrospective cross-sectional observational study was conducted among the tuberculosis patients that were also drug abusers. Tuberculosis treatment outcomes were categorized into six headings based on WHO recommendations (Cure, Treatment completed, Treatment failure, Died, Treatment interrupted and Transfer out). Out of total 850 tuberculosis patients that underwent Tuberculosis treatment, 104 (12.2%) were found to be confirmed drug abusers and were selected based on inclusion criteria. The subjects were predominantly males: 100 (96.2%) and a few females: 04(3.8%). Most of the patients were diagnosed with Pulmonary Tuberculosis: 91 (87.5%) whereas extrapulomanry tuberculosis was diagnosed in 13 cases (12.5%). A total of 79 cases (76%) were found to be positive for sputum culture or AFB smear, 25 cases (24%) were smear-negative type, 59 (53.8%) patients had hepatitis as co-morbidity (Tuberculosis and Hepatitis) and 15 (14.2%) patients were suffering from Tuberculosis with HIV/AIDS as a comorbidity. By end of study, a total of 37 (35.5%) drug addicts got cured, 20 (19.2%) completed their treatment and 20 (19.2%) interrupted the treatment, 24 (23%) drug addicts died during treatment and 03 were transferred to other health care facility. The success rate for anti-tuberculosis treatment was 54.8%. The anti-tuberculosis treatment success rate was found to be too low in comparison to target set by the WHO. A major reason for unsuccessful treatment of tuberculosis among drug abusers was found to be due to non-adherence or incomplete treatment. Adherence and compliance to therapy can be improved in such patients with DOTS-Plus treatment by using incentives and enablers.