Characteristics and Treatment Outcomes of Retreatment Tuberculosis Patients in Benin

Abstract

Objective. To determine among retreatment tuberculosis patients in Benin baseline characteristics, culture, and drug sensitivity testing (DST) results and treatment outcomes. Materials and Methods. A retrospective national cohort study of all retreatment tuberculosis patients in Benin in 2013 using registers and treatment cards. Results. Of 3957 patients with tuberculosis, 241 (6%) were retreatment cases. Compared to new pulmonary bacteriologically confirmed tuberculosis (NPBCT) patients, there were significantly higher numbers of males (P = 0.04), patients from “Atlantique-Littoral” (P = 0.006), patients aged 45–64 years (P = 0.007), and HIV-positive patients (P = 0.04) among those retreated. Overall, 171 (71%) patients submitted sputum for DST, of whom (163) 95% were positive for Mycobacterium tuberculosis on Xpert MTB/RIF and/or culture and 17 (10%) were rifampicin resistant (9 with MDR-TB and 8 monoresistant to rifampicin). For those without MDR-TB (n = 224), treatment success was 93%. Worse outcomes occurred in those with unknown HIV status (RR: 0.27; 0.05–1.45; P < 0.01) while better outcomes occurred in those who relapsed (RR: 1.06, 95 CI: 1.02–1.10, P = 0.04). Conclusion. In 2013, a high proportion of retreatment patients received DST. Treatment success was good although more needs to be done to systematically increase the final follow-up smear examination. Reasons of high losses to follow-up from “Oueme-Plateau” should be investigated.

First Insight into a Nationwide Genotypic Diversity ofMycobacterium tuberculosisamong Previously Treated Pulmonary Tuberculosis Cases in Benin, West Africa

“…This rate was slightly higher than what was observed by Affolabi et al in Benin in 2013 (10%) but was comparable to that of the national drug resistance survey in 2010 [24, 25]. Furthermore, this rate was similar to what was reported by Homolka et al among previously treated cases in Sierra Leone (14.4%) but was lower than 43.7% reported by Dia et al in Senegal [26, 27].…”

Antituberculosis Drugs Resistance and Treatment Outcomes Among Retreatment Patients in Guinea: A Five-Year Retrospective Cohort Study

“…Patients under 45 years were identified as the target of the disease in our study, eight out of ten. These findings were similar to those found in several studies [12,[18][19]. The predilection of MDR-TB for this more active population mostly drivers in our context, regularly carrying out high promiscuity and the high rate of retreatment failure should worry and lead health authorities and stakeholders involved in fighting TB to set-up new and effective strategies or interventions.…”

“…The high incidence of MDR-TB (eight out of ten) found in our study is widely above the literature data [12][13]. This could be attributed to the delay in referring TB clinically suspected cases to TB management services and the mismanagement of patients who are susceptible to anti-TB drugs, knowing that more than half of retreatment TB patients in our study were cases of first-or second-line treatment regimen failure.…”

“…The African region recorded between 36,000 and 44,000 MDR-TB cases in 2016. Studies conducted in Benin [12] and Burkina Faso [13] on patients who had previously received TB treatment, reported almost similar rates of MDR-TB, 52.9% and 50.5%, respectively.…”

Effect of Isoniazid Preventive Therapy on Tuberculosis Prevalence among HIV Patients Attending Bahati Comprehensive Care Centre, Nairobi, Kenya

“…The current findings confirm with other previous studies that retreatment patients are significantly associated to TB disease. The current study findings are slightly high than those documented in Ethiopia (53.8%) [23], on the other hand these findings are markedly high than previous findings in a study conducted in Benin (6%) [24], this difference may be attributed to lack of patient compliance to TB drugs, treatment interruptions due to either (imprisonment, defaulting) and weak active case finding strategies which allow re-infection of the already cured people, HIV prevalence [23]. Further findings of the current study indicated that a high percentage of male patients of age category 20-39 years had TB (14.1%), further the findings were markedly lower than those recorded in Thailand (43.7%) [25].…”