Abstract

PurposeThe purpose of this study was to assess tuberculosis (TB) treatment outcomes among new smear-positive pulmonary tuberculosis (PTB) patients and identify the risk factors of unsuccessful treatment outcomes in Kepong district, Kuala Lumpur, Malaysia.Design/methodology/approachA retrospective cohort study was conducted using registry-based data from the Tuberculosis Information System (TBIS) between 2014 and 2018. Simple random sampling was used to select 734 males and 380 females from the TBIS registry. Smear-positive PTB patient's sociodemographic, clinical and behavioral characteristics were extracted and analyzed. Logistic regression was used to find the possible independent risk factors for unsuccessful treatment outcomes.FindingsThe treatment success rate was 77.20% (n = 860) which was still below the target set by the WHO (>90%). In total, 254 patients showed an unsuccessful treatment outcome: 106 died, 99 defaulted, 47 not evaluated and 2 showed treatment failure. Unsuccessful treatment outcome was significantly associated with older age, male gender, non-citizen, unemployment and being HIV positive.Originality/valueThe study focuses on all these contributing factors of unsuccessful treatment outcome for a better risk assessment and stratification of TB patients and identify effective surveillance and management strategies to strengthen the control programs of tuberculosis in Kepong district.

Highlights

  • Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis

  • This study focuses on the risk factors associated with the unsuccessful treatment outcome among smear-positive TB patients

  • The majority (77.20%) showed a successful treatment outcome (Table 2), while 22.8% showed unsuccessful treatment outcome – 41.73% patient died, which was the largest group among those with an unsuccessful outcome followed by defaulters (38.97%), not evaluated (18.50%) and treatment failure (0.80%)

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Summary

Introduction

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Based on the World Health Organization (WHO) report, there was an increasing trend of estimated new TB cases from 2014 (9.6 million people) to 2018 (10 million people) [1]. In 2018, 1.5 million people died from TB [1]. In Malaysia, the estimated incidence rate of TB was at 92 cases per 100,000 population in 2018 [1]. The recording and reporting system of TB cases in Malaysia was strengthened by introducing the Tuberculosis Information System (TBIS).

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