Disease and treatment-related factors associated with tuberculosis treatment default in Khartoum State, Sudan: a case-control study

Ali, Ahmed Osman Ahmed; Prins, Martin H.

doi:10.26719/2017.23.6.408

Cited by 11 publications

(16 citation statements)

References 16 publications

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“…Our findings that patients living in rural areas had poorer treatment outcomes are similar to the findings of Ali and Prins [35]. Poorer outcomes could potentially be attributed to the distance to the treatment center and the cost of transportation despite the medicines being provided free of charge.…”

Section: Discussionsupporting

confidence: 83%

“…However, to date, there have only been a few studies on the outcomes of treatment of patients with MDR-TB in limited resource settings with high prevalence rates such as Sudan [30][31][32][33]. We are aware that there have been recent studies researching the incidence of TB as well as success rates for smear-positive TB between different parts of Sudan [34], reasons why TB patients default on their treatment including rural areas, adverse effects of treatment and previous history of TB [35], and that treatment outcomes in Sudan appear to be lagging behind current WHO targets [33]. However, we believe to date that treatment outcomes of MDR-TB, as well as possible factors related with poor treatment outcomes of MDR-TB, have not been reported in Sudan.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of multidrug-resistant tuberculosis (MDR-TB) treatment outcomes in Sudan; findings and implications

Ali

Alrasheedy

Kibuule

et al. 2019

Expert Review of Anti-infective Therapy

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Background: Multidrug-resistant tuberculosis (MDR-TB) has a socioeconomic impact and threatens global public health. We assessed treatment outcomes of MDR-TB and predictors of poor treatment outcomes in Sudan given current high prevalence rates. Methods: Combined retrospective and prospective cohort study at Abu-Anga hospital (TB specialized hospital in Sudan). All patients with MDR-TB between 2013 and 2017 were targeted. Results: A total of 156 patients were recruited as having good records, 117 (75%) were male, and 152 (97.4%) had pulmonary TB. Patients were followed for a median of 18 months and a total of 2108 person-months. The overall success rate was 63.5% and the mortality rate was 14.1%. Rural residency (P < 0.05) and relapsing on previous treatments (P < 0.05) were determinants of time to poor MDR-TB treatment outcomes. Conclusion: Overall, more attention needs to be given to special MDR-TB groups that are highly susceptible to poor outcomes, i.e. rural patients. As a result, it is highly recommended to maintain total coverage of medicines for all MDR-TB patients for the entire period of treatment in Sudan. It is also recommended to instigate more treatment centers in rural areas in Sudan together with programs to enhance adherence to treatments including patient counseling to improve future outcomes.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Assessment of multidrug-resistant tuberculosis (MDR-TB) treatment outcomes in Sudan; findings and implications

Ali

Alrasheedy

Kibuule

et al. 2019

Expert Review of Anti-infective Therapy

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“…The validated questionnaire was adapted after a careful review of the literature and translated into Arabic [1, 28–31]. The translation was performed by two bilingual professional translators who understood the content.…”

Section: Methodsmentioning

confidence: 99%

“…Tuberculosis (TB) is a curable and preventable disease, yet it remains a major public health concern in many parts of the world. Despite improved diagnosis, treatment, and prevention programs, it is responsible for the deaths of more young and middle-aged adults than any other infectious disease [1]. According to the World Health Organization (WHO) the incidence of TB worldwide is around 10.4 million cases each year, with 1.5 million deaths occurring annually [1–3].…”

Section: Introductionmentioning

confidence: 99%

“…Despite improved diagnosis, treatment, and prevention programs, it is responsible for the deaths of more young and middle-aged adults than any other infectious disease [1]. According to the World Health Organization (WHO) the incidence of TB worldwide is around 10.4 million cases each year, with 1.5 million deaths occurring annually [1–3]. More than 90% of these deaths are reported from low- and middle-income countries, and this figure is probably still an underestimate of the actual numbers of fatalities caused by the disease [3, 4].…”

Section: Introductionmentioning

confidence: 99%

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High non-compliance rate with anti-tuberculosis treatment: a need to shift facility-based directly observed therapy short course (DOTS) to community mobile outreach team supervision in Saudi Arabia

Alsahafi¹,

Shah²,

Al-Sayali³

et al. 2019

BMC Public Health

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Background Tuberculosis (TB) remains a major global public health problem in many developing countries including Kingdom of Saudi Arabia (KSA). Patient compliance with anti-tuberculosis treatment is a determining factor in controlling the spread of TB. This study compares the default rate and the perception of their treatment among TB patients being treated by means of a community mobile outreach approach, with those of patients being treated by means of a facility-based Directly Observed Treatment Short course (DOTS) in the Jeddah region of Saudi Arabia. Methods A comparative cross-sectional study of 200 TB patients who presented at the Madain Alfahd Primary Health Care Center (PHCC) Jeddah, between January 2018 and November 2018 was undertaken. In one group, randomly assigned patients were served by mobile outreach teams who administered oral anti-TB treatment under the DOTS regime. In the other group, the patients were treated by means of the traditional facility-based DOTS treatment. A questionnaire measuring patient attitudes and understanding of the disease and their treatment modes was completed by patients at the beginning of their treatment, and again after 3 months. The results were analysed by means of independent and Paired T Tests, along with chi square analysis. Results We found that the overall default rate among those patients served by our mobile outreach team was only 3%, compared with a 22% default rate among non-mobile team treated patients ( p = < 0.001). A major change in the attitude and understanding scores of patients was noted in both groups after 3 months. A significant difference was also noted in the mean compliance scores (mobile team served =58.43 and facility-based =55.55, p < 0.001) after 3 months of treatment. Conclusion Our study indicated that treatment by means of our mobile outreach DOTS can offer an effective strategy for the treatment of TB patients. A reduced patient default rate and a better understanding of the disease and its treatment confirmed a positive impact of mobile outreach teams on these patients. Treating TB patients by means of mobile outreach teams can thus be recommended as a means for the cure and prevention of the further spread of the disease.

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Association ofNRAMP1-INT4 gene with Susceptibility to Tuberculosis in the Sudanese Population: A Case-Control Study

Mohamed

Elaagip

SalahEldin

et al. 2021

Preprint

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Background: Sudan is a Sub-Saharan African country with a high prevalence rate of Tuberculosis. Natural Resistant Associated Macrophage Protein 1 (NRAMP1) plays a potential role in the development of immunity against TB, and it has a critical role in disease resistance. The aim of the study was to evaluate the association of NRAMP1 polymorphism at intron4 (INT4) region with susceptibility to TB infection. Methods: Demographic, clinical and microbiological data were collected from 150 participants and investigated using designed questionnaire. The genotyping of NRAMP1-INT4 polymorphism was performed in 60 TB-infected patients and 50 healthy control using Polymerase chain reaction and restriction fragment-length polymorphism method (PCR-RFLP). Results: Among cases (60%) were males, only (3.3%) were vaccinated. The most reported risk factors were tobacco smoking (17%), diabetes (10%), alcohol consumption (2%) and corticosteroid therapy intakes (1%). Pulmonary TB was detected in 67% of the patients, 24% had pulmonary/MDR and 9% had extrapulmonary TB. The frequency of wild G allele was significantly higher in cases compared with healthy control subjects (P-value <0.0001). Also, a significant association was observed between the heterozygosity for NRAMP1-INT4 variant and resistance to TB infection (P-value 0.001, OR= 4.83, 95%CI 1.96~11.88). Homozygotes mutant INT4 (C/C) genotype was not detected in both cases and controls. Conclusions: the NRAMP1-INT4 polymorphism may serve as marker of unidentified genetic factors that may play a critical role in host immunity to TB in the Sudanese population. Further studies with large sample size are recommended to determine population-specific genetic associations with TB susceptibility in order to guide TB therapy and prophylaxis in a population-specific manner. Keywords: M. tuberculosis, MDR, NRAMP1, SNP, Sudan.

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Disease and treatment-related factors associated with tuberculosis treatment default in Khartoum State, Sudan: a case-control study

Cited by 11 publications

References 16 publications

Assessment of multidrug-resistant tuberculosis (MDR-TB) treatment outcomes in Sudan; findings and implications

Assessment of multidrug-resistant tuberculosis (MDR-TB) treatment outcomes in Sudan; findings and implications

High non-compliance rate with anti-tuberculosis treatment: a need to shift facility-based directly observed therapy short course (DOTS) to community mobile outreach team supervision in Saudi Arabia

Association ofNRAMP1-INT4 gene with Susceptibility to Tuberculosis in the Sudanese Population: A Case-Control Study

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