Tuberculosis Treatment Success Rate Research Articles

KNOWLEDGE, FAMILY SUPPORT, AND COMPLIANCE FOR PULMONARY TUBERCULOSIS MEDICATION AMONG TUBERCULOSIS PATIENTS IN THE WORKING AREA OF REMBANG PUBLIC HEALTH CENTER, PASURUAN

Background: Tuberculosis (TB) is a disease caused by the bacterium Mycobacterium tuberculosis, which is an aerobic bacterium that can live mainly in the lungs or in various other organs of the body. According to the Health Profile of East Java Province in Pasuruan Regency in 2020, based on the achievement of TB treatment success rates as many as 18 districts/cities that have reached the target of treatment success of 91.510%. Objective: The purpose of this study was to determine the relationship between knowledge and family support with adherence to taking anti-tuberculosis drugs in TB patients in the Rembang Public Health Center, Pasuruan Regency. Methods: This study used a cross sectional research design with a sample of 27 respondents with pulmonary TB undergoing treatment at the Rembang Public Health Center. Data was collected using a questionnaire with an ordinal scale which was then analyzed using the Spearman Rank statistical test. Result: Data collection of knowledge with medication adherence with a correlation coefficient of .505 with a significant p-value = .000. Collecting data on family support with medication adherence with a correlation coefficient of .487 with a significant p-value = .000. Conclusion: It was concluded that there was a relationship between knowledge and family support with adherence to taking anti-tuberculosis drugs. The higher a person's education and family support, the more quickly they receive and understand information so that the knowledge and support from their family is also higher.

Diabetes mellitus is associated with an increased risk of unsuccessful treatment outcomes among drug-susceptible tuberculosis patients in Ethiopia: A prospective health facility-based study

BackgroundThe impact of diabetes mellitus on tuberculosis (TB) treatment outcomes has not been well investigated in most sub-Saharan countries including Ethiopia. The current study aimed to determine the association between diabetes mellitus and unsuccessful TB treatment outcomes among drug-susceptible TB patients treated at selected health facilities in Addis Ababa, Ethiopia. MethodsThis health facility-based prospective cohort study was conducted at six randomly selected public health centers in Addis Ababa, from August 2020 until November 2021. Clinically diagnosed adult pulmonary and extra pulmonary TB patients were recruited at the time of treatment initiation. A multivariable logistic regression analysis was used to estimate the association between diabetes and unsuccessful TB treatment outcomes. ResultsAmong the total 267 enrolled participants, 9.7% of patients with TB were identified to have diabetes comorbidity. Of patients with diabetes and TB, 9 (34.6%) were newly diagnosed based on glucose test results. Despite an overall high TB treatment success rate (94.0%), more than one-fourth (26.9%) of patients with diabetes had a poor TB treatment outcome (26.9%), which was remarkably higher compared to patients without diabetes (3.7%). In multivariable regression, the adjusted odds of poor TB treatment outcome among those with diabetes was 14.8 (95% CI 3.5 – 62.7) times the odds of poor outcome patients without diabetes. ConclusionDiabetes was significantly associated with increased odds of poor TB treatment outcomes among patients in Addis Ababa, Ethiopia.

The psychic pathologies and factors associated with tuberculosis

Patients with psychological patologies have an increased risk for tuberculosis. The aim of the study was to identify the types of the psychic pathologies and other factors associated with development of tuberculosis. A selective, analytical and retrospective study was conducted, which included 71 tuberculosis patients diagnosed psychic pathologies registered in the period 2015-2019. The results of the study established that the particularities of the patients were male sex (58 (81.7%) cases), age between 35 and 64 years (48 (67.9%) cases), low socio-economic status (67 (85.9%) cases), poor living conditions - 58 (81.7%) cases. The risk factors for acquiring the disease were the tuberculosis contact - 12 (16.9%) and associated pathologies, including TB/HIV co-infection in 11 (15.5%) cases. Pulmonary localization of tuberculosis predominated in 61 (85.9%) cases. Therapeutic success was established in only 37 (52.1%) cases and death occurred in 20 (28.1%).. The low success rate of tuberculosis treatment has shown that the treatment requires individualized according to the patient’s needs.

Tuberculosis and COVID-19 co-infection in Serbia: Pandemic challenge in a low-burden country.

COVID-19 and tuberculosis (TB) represent global threats to the public health system. The impact of COVID-19 on TB results in a reduction in the number of notified TB cases, delayed diagnosis and treatment, and increased case fatality and mortality rates. The aim of the study was to analyze the TB/COVID-19 co-infected cohort in Serbia as a low-burden country and compare it to the global TB/COVID-19 cohort. A retrospective analysis was done on 53 TB and COVID-19 co-infected patients treated in COVID hospital "Batajnica" in Belgrade and Special Hospital for Pulmonary Diseases "Ozren" Sokobanja in the period from 6 March 2020 to 1 April 2022. A comparative analysis with the global cohort published recently was also performed. TB/COVID-19 cohort in Serbia included significantly fewer migrants and diabetes cases, but more cases with chronic respiratory diseases compared to the global. Descriptive analysis of TB cases in the Serbian TB/COVID-19 cohort showed fewer cases diagnosed with sputum smear and Gene Xpert/HAIN, fewer EPTB and mono-resistant cases, and more cases diagnosed with solid culture, unilateral pulmonary infiltrate (with bilateral cavity lesions), and bilateral pulmonary infiltrate (no cavities) compared to TB/COVID-19 cases worldwide. Nasal congestion and fever were more common COVID-19 symptoms in the global cohort. Radiology was more commonly used for the diagnosis of COVID-19 in Serbia. Typical bilateral ground opacities were less common among Serbian patients. Serbian patients spent fewer days in the hospital and achieved a higher PCR conversion rate and TB treatment success rate. The Serbian TB/COVID-19 cohort achieved a higher treatment success rate compared to the global cohort. Encouraging vaccination against SARS-CoV-2 for people with a current or past TB disease, as well as rapid diagnosis and targeted treatment of TB in highly specialized pulmonology institutions, presents key points to avoid excessive morbidity and mortality.

Drug-susceptible tuberculosis treatment outcomes and its associated factors among inmates in prison settings in Bauchi State, Nigeria, 2014-2018.

Tuberculosis (TB) is a contagious disease and its transmissibility is increased in congregate settings. TB incidence rates are five-to-fifty times higher among inmates in prison settings than the general population which has a direct impact on the outcome of TB treatment. There is paucity of information on TB treatment outcomes and its associated factors in Nigerian prison settings. We therefore assessed TB treatment outcomes among inmates in prison settings in Bauchi State, Nigeria. We conducted a retrospective data analysis of inmates with TB in the five-main prison settings in Bauchi State. We extracted socio-demographic, clinical and treatment outcome characteristics from TB treatment register of inmates treated for TB between January 2014 and December 2018, using a checklist. We calculated the TB treatment success rate (TSR) and explored the relationship between the TSR and socio-demographic and clinical characteristics. Related variables were modelled in multiple logistic regression to identify factors associated with TSR at 5% level of significance. All 216 inmates were male with mean (SD) age of 37.6±11.4 years. Seventy-six (35.2%) were cured, 61 (28.2%) completed treatment, 65 (30.1%) were transferred-out without evaluation and 14 (6.5%) died. Overall TSR was 72.9%. Factors associated with successful-treatment-outcome were age, weight, imprisonment duration and HIV status. The results indicate that inmates who are 20–29 years are at least ten times more likely to be successful (aOR = 10.5; 95%CI: 3.2–35.1) than inmates who are 55 years or older. Inmates who are 30–39 years are about four times more likely to be successful than inmates who are 55 years or older (aOR = 4.2; 95% CI: 1.3–13.1). In general, the younger an inmate, the more successful he is. Inmates with pretreatment-weight; 55kg or more are 13 times more likely to be successful (aOR = 13.3; 95%CI: 6.0–29.6) than inmates with weight below 55kg. Inmates who were imprisoned for 2 years or less are about three times more likely to be successful (aOR = 2.6; 95%CI: 1.3–5.4) than inmates who were imprisoned for more than 2 years and HIV negative inmates were three times more likely to succeed (aOR = 3.3; 95%CI:1.4–7.8) than inmates who were HIV positive. We recommended that to improve TB treatment outcome among inmates; age, duration-of-imprisonment, weight and TB/HIV co-infection should be the major consideration during pretreatment, psychological and nutritional counselling and a tracking-system be developed by the authority to follow-up inmates transferred-out to other health facilities to ensure they complete the treatment and outcomes evaluated.

Outcomes and predictors of tuberculosis mortality in Kweneng West District, Botswana: a retrospective cohort study

IntroductionBotswana is among the countries with the highest tuberculosis (TB) notification rates in the world. However, there is paucity of data on the outcomes and predictors of TB mortality at district level in Botswana. This study was aimed at describing the TB outcomes and identifying the predictors of mortality in Kweneng West district, Botswana.Methodsthis was a retrospective cohort study of TB outcomes in Kweneng West, from January 2008 to December 2016. All documented drug-sensitive TB (DS-TB) patients aged 16 years and above were included. The World Health Organization (WHO) definitions of treatment outcomes for DS-TB were used. Binary logistic regression was used to identify predictors of mortality.Resultsthere were 1475 TB notifications in the study period. The median age was 36 years and 41.5% were female. A total of 728 (49.4%) were HIV positive. Pulmonary TB (PTB) accounted for 87.3% of all cases. The overall treatment success rate (TSR) was 81.9% and the mortality rate was 9.4%. Compared to the 16-25 years age group, patients aged more than 65 years had the highest risk of mortality (AOR=9.63). Other significant predictors of mortality were male sex (AOR=1.63), no sputum microscopy (AOR=1.77), positive HIV (AOR=2.13) and unknown HIV status (AOR=4.47). Positive sputum microscopy (AOR=0.50) and extra-pulmonary TB (EPTB) (AOR=0.56) were associated with less mortality.Conclusionwhile Botswana has relatively good TB treatment success rates, the mortality rates are high. Public health interventions should target the identified risk factors of mortality.

Poor adult tuberculosis treatment outcome and associated factors in Gibe Woreda, Southern Ethiopia: An institution-based cross-sectional study.

Tuberculosis (TB) remains a major medical and public health problem throughout the world, especially in developing countries including Ethiopia. Its control program is currently being challenged by the spread of drug-resistant TB, which is the result of poor treatment outcomes. Hence, this study assessed poor adult TB treatment outcomes and associated factors in Gibe Woreda, Southern Ethiopia. An institution-based cross-sectional study was conducted from March 1, 2020 to March 30, 2020, using a standard checklist to review clinical charts of TB patients who enrolled on first-line TB treatment under DOTS between June 2016 and June 2019. Poor treatment outcomes constituted death during treatment, treatment failure, and loss to follow-up (LTFU). Descriptive statistics were used to describe the characteristics of study participants. A binary logistic regression model was fitted to identify factors influencing treatment outcome and adjusted odds ratios with a 95% confidence interval were reported. The statistical significance of all tests in this study was declared at P-value <5%. A total of 400 adult TB patients were participated. The mean age of study participants was 39.2±16.7 years, 55.5% were males and 79.8% were pulmonary tuberculosis cases. Regarding the treatment outcomes, 58% completed treatment, 27.5% cured, 9.3% were LTFU, 3.2% died, and 2.0% failed. The overall poor treatment outcome was 14.5% (95% CI: 11.1-17.9). Age (aOR = 1.02; 95%CI: 1.01-1.04), male gender (aOR = 1.82; 95% CI: 0.99-3.73), travel ≥ 10 kilometres to receive TB treatment (aOR = 6.55; 95% CI: 3.02-14.19), and lack of family support during the course of treatment (aOR = 3.03; 95% CI: 1.37-6.70), and bedridden baseline functional status (aOR = 4.40; 95% CI: 0.96-20.06) were factors associated with poor treatment outcome. Successful TB treatment outcome in this study area was below the national TB treatment success rate. To improve positive treatment outcomes, remote areas should be prioritized for TB interventions, and stakeholders in TB treatment and care should give special emphasis to adults over the age of 45 years, males, those who travel more than 10 kilometres to receive TB care, having bedridden baseline functional status and those who had no family support.

Impact of COVID-19 pandemic on TB prevention and care in Addis Ababa, Ethiopia: a retrospective database study

ObjectiveThe current COVID-19 pandemic in Ethiopia could cause severe dysfunction in tuberculosis (TB) treatment, diagnostic services, and prevention and control efforts. In this study, we evaluated the effect of COVID-19...

Effect of a brief motivational interview and text message intervention targeting tobacco smoking, alcohol use and medication adherence to improve tuberculosis treatment outcomes in adult patients with tuberculosis: a multicentre, randomised controlled trial of the ProLife programme in South Africa

ObjectiveTo investigate the effectiveness of a complex behavioural intervention, ProLife, on tuberculosis (TB) treatment success, medication adherence, alcohol use and tobacco smoking.DesignMulticentre, individual, randomised controlled trial where participants were assigned...

Outcomes of tuberculosis treatment in a tertiary health facility in north-central Nigeria

Background: Tuberculosis (TB) remains a major public health concern despite being a curable and preventable disease. The treatment of TB using a cocktail of drugs over a period of six months under the directly observed treatment short-course strategy has led to a reduction in cases but is plagued by some challenges that leads to unsuccessful or poor outcomes, which can ultimately result in spread of infections, development of drug resistance and increase in morbidity and mortality. The objectives of this study are to determine outcomes of TB treatment in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria and the factors that may be associated with the outcomes.&#x0D; Methodology: This was a retrospective study using the medical records of patients who were registered for TB treatment over a five-year period between 2016 to 2020. Data from TB registers including demographic and relevant clinical information, and treatment outcomes, were extracted into a structured data extraction format, and analysed with SPSS version 21.0 software package. Univariate and bivariate analyses were conducted, and Chi square test was used to determine association between TB outcomes and independent variables at 95% confidence interval and p&lt;0.05 was considered as the significant value.&#x0D; Results: Records of 1,313 patients were studied, 744 (56.7%) were males while 569 (43.3%) were females. The age range of the patients was ≤ 1 year - 96 years, with a mean age of 30±16.7 years. Most were pulmonary TB cases (88.8%, n=1,166), newly diagnosed (95.5%, n=1254), and human immunodeficiency virus (HIV) negative at the time of TB diagnosis (63.7%, n=837). Eight hundred and seven (61.5%) patients had successful treatment, and 34% (n=446) had unsuccessful outcomes made of ‘loss to follow-up’ 25.8% (n=339), deaths 7.8% (n=102) and treatment failure 0.4% (n=5), while 2.3% (n=30) were transferred out and 2.3% (n=30) removed from TB register. Treatment success rate was significantly higher in patients with pulmonary TB (p=0.0024), residents in Lafia LGA (p=0.0005), those treated in 2016 (p=0.0006) and bacteriologically confirmed cases (p&lt;0.0001), while death rate was significantly lower among patients who were HIV-negative at the time of TB diagnosis (p&lt;0.0001).&#x0D; Conclusion: TB treatment success rate in this study fell short of the WHO average rate. High rates of ‘loss to follow-up’ and deaths in this study is a wake-up call to all stakeholders in the facility and the State to put in place measures to reduce poor outcomes of TB treatment.

Epidemiology of coinfection with tuberculosis and HIV in Japan, 2012-2020.

This report examines the characteristics and treatment outcomes of patients with tuberculosis (TB) who are coinfected with HIV in Japan. Active TB cases newly notified to the Japan Tuberculosis Surveillance system during 2012–2020 were analysed retrospectively, during which 379 HIV-positive TB cases were reported. The proportion of HIV-positive cases among those with known HIV status increased, from 1.9% (62/3328) in 2012 to 3.5% (31/877) in 2020. The proportion of those with unknown HIV testing status was consistently high, at approximately 60%, and the proportion of those who did not undergo HIV testing increased significantly, from 21.6% (4601/21 283) in 2012 to 33.7% (4292/12 739) in 2020. The proportion of foreign-born cases more than tripled, from 14.5% (9/62) in 2012 to 45.2% (14/31) in 2020. The TB treatment success rate was higher among HIV-negative than HIV-positive cases (72.7% [3796/5222] versus 60.3% [88/146]), and among Japan-born than foreign-born HIV-positive patients (65.6% [61/93] versus 50.9% [27/53]), owing largely to the high rate of foreign-born cases transferring to care outside Japan. The increasing proportion of HIV positivity among TB cases tested for HIV in this study requires ongoing monitoring, especially among foreign-born persons. However, because the number of reported cases was small, and there was low completeness of reporting of HIV testing data in the TB surveillance system, these results should be interpreted with caution. Encouraging more complete data collection by training public health nurses who complete TB case interviews and ensuring ongoing monitoring of patients with TB/HIV coinfection are recommended.

Treatment Outcomes Among Notified Pulmonary Tuberculosis Cases in 67 Refugee Health Facilities in the Eastern Africa-IGAD Region: Historical Cohort, 2014-2017

Background: Refugees are at increased risk for Tuberculosis (TB). In 2020, more than 3.9 million refugees were hosted in refugee camps/settlements in member countries of Intergovernmental Authority on Development (IGAD), East Africa. Regional evidence, therefore, on treatment outcome is important to improve the quality of TB care and strengthen the monitoring and evaluation system in the refugee settings. Objective: To assess trends of pooled TB treatment outcomes at the regional level and identify factors associated with unsuccessful treatment outcome among patients with pulmonary TB (PTB), bacteriologically confirmed pulmonary TB (BCPTB) and clinically diagnosed pulmonary TB (CDPTB) in refugee camps in IGAD region from 2014 to 2017. Methods: A retrospective cohort study was conducted in 67 refugee health facilities located in four countries (Ethiopia=25, Uganda=33, Kenya=5 and Sudan=4). Demographic and clinical data of all PTB patients registered between January 1, 2014 and December 31, 2017 were used. Descriptive analysis was done on the data and multivariate logistic regression analysis was used to identify baseline covariates associated with unsuccessful treatment. Results: A total of 4,072 TB cases (42%, 28%, 12% and 19% were from Kenya, Ethiopia, Sudan, and Uganda respectively) were included with more than half (62.4%) being BCPTB. 59.2% were males and 13.5% were HIV co-infected. The pooled treatment success rate (TSR) in the period under review was 80.7%. TSR was higher among the CDPTB compared to BCPTB cases in 2014 (86.5% vs. 81.3%), 2015 (87.5% vs. 84.8%) and 2016 (81.0 vs. 80.6%); but reversed in favour of BCPTB in 2017 (77.1% vs. 74.3%). Overall, 13.6% of the cases had unsuccessful treatment (treatment failed, died, or lost to follow-up). The factors significantly associated with unsuccessful treatment were positive HIV status (aOR 2.6[CI: 1.7 - 4.2]), male gender (aOR 1.7[CI: 1.4 - 3.8]), previous TB history (aOR 1.5[CI: 1.0 - 2.2]) and older age (aOR 1.7[CI: 1.1 - 2.8]). Conclusion: TB Treatment success rate in the refugee camps remained below the global target (≥ 90). TB-HIV co-infection, Male gender, previous history of treatment and age (15-34 &amp;old age) increased the risk for unsuccessful treatment outcomes among PTB patients in the refugee camps.

Impact of HIV-AIDS on tuberculosis treatment outcome in Southern Ethiopia – A retrospective cohort study

BackgroundGlobally, the Tuberculosis treatment success rate was worse for HIV-positive TB patients compared with HIV- negative TB patients. This study aimed at determining the impact of HIV-AIDS and factors associated with TB treatment outcomes. MethodsThis study was a retrospective cohort study of five years of tuberculosis data from four public health facilities in Hosanna Town. A total of 604 study participants were included using a systematic random sampling technique. Descriptive analysis of ratios, rates, and proportions was done and binary logistic regression, bivariable and multivariable, analysis was also done. ResultA total of 604 TB patients were enrolled in this study. 302 (50%) were HIV co-infected. The overall treatment success rate was 90.1% (544/604). Treatment success rates are 86.4% (261/302) for TB-HIV co-infected patients and 93.7% (283/302) for non-co-infected patients. TB-HIV co-infected patients had a higher risk of an unsuccessful treatment outcome (Adjusted Relative Risk [ARR]: 2.7; 95% Confidence Interval [CI]: 1.4 – 5.2). The risk of unsuccessful treatment outcome is also higher among rural residents (ARR: 3.3; CI: 1.4 – 5.0), patients on the re-treatment category (ARR: 2.7; CI: 1.4 – 5.1), and with chronic disease (ARR: 3.3; CI: 1.3 – 8.1). ConclusionTB treatment success rate is good as compared to the WHO minimum requirement. Successful treatment outcome is lower among patients with HIV infection, rural residents, patients on re-treatment, and patients with chronic disease. Therefore, due emphasis should be given to these high-risk groups.

Tuberculosis Treatment Outcomes and its Associated Factors in a Tertiary Health Center in Southwestern Nigeria

Background: Monitoring and evaluation of tuberculosis (TB) treatment outcome is an essential component of the evaluation of a country's TB control program. Nigeria's current TB treatment success rate of 86% is below the World Health Organization target of 90% by 2025. This study aims to evaluate TB treatment outcomes in a tertiary health center in southwestern Nigeria over a 5-year period and to document the factors associated with poor TB treatment outcomes. Materials and Methods: This was a retrospective study of all TB patients seen at the TB clinic of the hospital from January 1, 2015, to December 31, 2019. Data were extracted from the TB clinic register. Data extracted included sociodemographic factors, HIV status, treatment category, rifampicin resistance, extrapulmonary TB, and treatment outcome. Treatment outcome was categorized as successfully treated or poor treatment outcome (death, treatment failure, and lost to follow-up). Results: Five hundred and nine TB cases were analyzed with a mean (standard deviation) age of 40.2 (17.7) years. Treatment outcome was as follows: successfully treated – 426 (83.7%), died – 62 (12.2%), treatment failure – 14 (2.8%), and lost to follow-up – 7 (1.4%). Poor treatment outcome was associated with older age (P = 0.003), HIV-positive status (P = 0.044), and smear-negative TB (P = 0.047). Conclusion: The treatment success rate in our center is high but can be improved. More efforts should be put in place to ensure improved outcomes, particularly among the elderly and HIV-positive patients.

Social and health factors associated with unfavourable treatment outcome in adolescents and young adults with tuberculosis in Brazil: a national retrospective cohort study

Tuberculosis elimination strategies in Brazil might neglect adolescents and young adults aged 10-24 years, hampering tuberculosis control. However, little is known about factors associated with tuberculosis treatment outcomes in this underserved group. In this study, we aimed to investigate social and health factors associated with unfavourable treatment outcomes in young people with tuberculosis in Brazil. A national retrospective cohort study was done using data from Sistema de Informação de Agravos de Notificação (SINAN), the national tuberculosis registry in Brazil. People aged 10-24 years (young people) with tuberculosis registered in SINAN between Jan 1, 2015, and Dec 31, 2018, were included. Unfavourable outcomes were defined as loss to follow-up, treatment failure, and death. Favourable outcome was defined as treatment success. Multiple logistic regression models estimated the association between social and health factors and tuberculosis treatment outcomes. 67 360 young people with tuberculosis were notified to SINAN, and we included 41 870 young people in our study. 7024 (17%) of the 41 870 included individuals had unfavourable treatment outcomes. Young people who received government cash transfers were less likely to have an unfavourable outcome (adjusted odds ratio 0·83, 95% CI 0·70-0·99). Homelessness (3·03, 2·07-4·42), HIV (2·89, 2·45-3·40), and illicit drug use (2·22, 1·93-2·55) were the main factors associated with unfavourable treatment outcome. In this national cohort of young people with tuberculosis in Brazil, tuberculosis treatment success rates were lower than WHO End TB Strategy targets, with almost a fifth of participants experiencing unfavourable treatment outcomes. Homelessness, HIV, and illicit drug use were the main factors associated with unfavourable outcome. In Brazil, strategies are required to support this underserved group to ensure favourable tuberculosis treatment outcomes. Wellcome Trust, UK Medical Research Council, and UK Foreign Commonwealth and Development Office.

Improving tuberculosis treatment success rate through nutrition supplements and counselling: Findings from a pilot intervention in India

In India, the estimated incidence of tuberculosis cases for the year 2018 was 2.69 million. According to WHO, it was responsible for 32 deaths/100,000 population. India also faces a dual burden of tuberculosis and malnutrition which represents an alarming situation. With this backdrop, the current study tries to assess the change in weight and BMI among active TB patients in selected intervention and control site. The study also measures the treatment success rate of the patients. This pilot study was conducted among 282 active TB patients in Dhar district of Madhya Pradesh state of Central India and the results were compared with a control site. The intervention included, providing the identified TB patients with monthly nutrition food baskets, nutrition counselling, linking to treatment and promoting its adherence, community mobilization and management and linkages to government schemes. The data for this study was taken from the project Management Information System (MIS).The results indicate that the mean weight for both male and female TB patients increased significantly during each food distribution episode. At the beginning of the intervention the mean weight of the TB patient was 42.9 kg which increased gradually to 49.3 kgs at the end of the intervention. Treatment success rate in the intervention group was recorded as 95% whereas in the control group it was 83.5%.The study strongly confirms that the nutritional supplements and regular counselling can help TB patients gain weight and have greater treatment success rate.

The trend of tuberculosis case notification and predictors of unsuccessful treatment outcomes in Samdrup Jongkhar district, Bhutan: A fourteen-year retrospective study

Tuberculosis (TB) continues to be an important public health issue in Bhutan. This study aims to describe the trend of tuberculosis and investigate factors associated with a unsuccessful treatment outcome in Samdrup Jongkhar District in Bhutan.A fourteen-year (2004–2017) case records in two TB centres of Dewathang and Samdrup Jongkhar Hospitals were reviewed and analyzed to examine trends in case notification and treatment outcomes. Univariable and multivariable logistic regression analysis was undertaken to identify covariates of unsuccessful TB treatment.Of the total of 820 TB cases registered in surveillance record, 729 cases were analysed. Males made up 53.8% (397) of total cases and the median age was 29 years (range: 2–87 years). A gradual downward trend in TB case notification was noticed in the district with overall case notification rate of 139/100,000 during the study period. The annual treatment success rate was over 90% except for years 2013–2015 with overall treatment success rate for the study period at 93%. A re-treatment TB patient, sputum-positive at the second month of treatment and being of Indian nationality were significant correlates of unsuccessful treatment outcomes. The overall TB inclidence has declined and TB treatment success rate was above WHO recommended 90% in Samdrup Jongkhar District during the study period. A special attention should be paid to the poor treatment outcome predictors including re-treatment cases and failed sputum conversion at the second month of treatment.

Geographically weighted models for modelling the prevalence of tuberculosis in Java

Indonesia’s position as one of the high burden countries for the infectious disease, tuberculosis (TB), has caused TB to be a major health problem in Indonesia. As means to control the number of TB cases, it becomes important for the government to identify factors associated with it. Commonly, multiple linear regression models are used to evaluate the linear relationship between the identified factors and the number of TB cases. Unfortunately, this model does not have the ability to expose the spatial variation in the data. Therefore, this study proposes to implement a spatial model: a model that takes the geographical location in the model. This research examined two types of geographically weighted models (GWM): geographically weighted regression (GWR) and mixed geographically weighted regression (MGWR). These spatial models assign weights to observations based on its’ geographical location. These two models were constructed to evaluate the relationship between the prevalence of TB in regency/city in Java in 2017 and the factors associated with it: population size, success rate of TB treatment, percentage of toddlers receiving BCG vaccine, percentage of HIV patient, percentage of household with adequate sanitation, percentage of poor people and the number of public health centre per one hundred thousand people. Akaike’s Information Criterion (AIC) and adjusted R2 were used to assess the model performances. We found that the GWR model fits the data better than MGWR, as it has a smaller AIC value (1558.67) and a higher adjusted R2 (0.754). It is also found that BCG vaccine is important to reduce the prevalence of TB, as the percentage of toddlers receiving BCG vaccine is negatively associated with it. Among the examined areas, Jakarta is the area with the highest association between the percentage of toddlers receiving BCG vaccine and the prevalence of TB.

Tuberculosis Treatment Outcome and Associated Factors Among Tuberculosis Patients Under Directly Observed Treatment Short-Course at Arba Minch General Hospital, Southern Ethiopia: A Five-Year Retrospective Study

Background: Although directly observed treatment short course has been implemented among different countries, tuberculosis (TB) remains a major public health issue in the 21 st century and Ethiopia is the eighth highest-burden country in the world. Thus, assessment of TB treatment outcomes and its associated factors in DOTS are among the major indicators of the performance of a national TB control program. Objective: The aim of this study was to assess tuberculosis treatment outcome and associated factors among TB patients under directly observed treatment short-course at Arba Minch General Hospital TB clinic, Southern Ethiopia from September 2015 to August 2020.MethodsAn Institutional based retrospective study was conducted by reviewing the five years (1 st September 2015 to 30 th August 2020) TB treatment registries at the TB clinic of Arba Minch General Hospital. A total of 498 TB patients from the registration with complete information were enrolled. Patients’ data like age, sex, residence, type of TB, the status of TB case, smear result of PTB, HIV co-infection, year of TB diagnosis, and treatment outcomes were extracted from the TB treatment registration with a data collection checklist. SPSS version 25 statistical software was used for final data analysis. Results: From the overall enrolled TB patients, 312 (62.7%) were males and about 286 (57.4%) were from rural areas. In terms of TB type 94% were pulmonary TB, of which 66% were smear negative (PTB-) and 86.3% were new TB cases. The proportion of TB/HIV co-infection was 17.7%. Overall, 440 (88.4%) TB patients had successful treatment outcomes (28.5% cured and 59.9% completed treatment), while 11.6% patients had unsuccessful treatment outcomes (7.8% defaulted, 2.2 died, and 1.6% treatment failure). The unsuccessful TB treatment outcome was significantly associated with re-treatment TB cases [AOR=3.345, 95% CI: (1.739-6.436)], smear-negative PTB cases, [AOR = 2.558, 95% CI: (1.229-5.323)] and with EPTB [AOR = 4.817, 95% CI: (2.101-11.044)]. Conclusion: The high TB treatment success rate in our setting is in line the target set by the WHO. However, successful treatment outcome was very law in EPTB, re-treatment, and smear negative PTB cases. Therefore, targeted measures should be considered to decrease poor tuberculosis treatment outcomes among high-risk patients through; careful monitoring, making the DOTS program more accessible and counselling. Funding: This research was supported by Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Southern Ethiopia. Declaration of Interest: The authors declare that they have no conflicts of interest for this work. Ethical Approval: This study was approved by the Arba Minch University, College of Medicine and Health Sciences, Department of Medical Laboratory Sciences

ANALISIS FAKTOR YANG BERPENGARUH TERHADAP KONVERSI SPUTUM BASIL TAHAN ASAM PADA PENDERITA TUBERKULOSIS

Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. The incidence of tuberculosis in Indonesia is high because the success rate of tuberculosis treatment has decreased which causes the chain of transmission continues to occur. The main government programs to decrese the incidence and increasing the success treatment with the Directly Observed Treatment (DOTS) program. One important indicator of the DOTS program to assessing the success of tuberculosis treatment is the conversion of positive AFB sputum to negative at the end of the intensive phase of treatment. AFB sputum conversion to negative at the end of the intensive phase of treatment is influenced by several internal factors such as level of education and income, gender, adherence, patient's nutritional status, and comorbidities. Then external factors can also influence the AFB sputum conversion in anti-tuberculosis treatment such as environmental conditions, smear positivity, drug taking supervisors (PMO), and availability of drugs in health facilities.