Factors affecting treatment outcomes in drug-resistant tuberculosis cases in the Northern Cape, South Africa

Elliott, Elizabeth; Draper, Heather R.; Baitsiwe, P.; Claassens, Mareli

doi:10.5588/pha.14.0029

Cited by 16 publications

(17 citation statements)

References 6 publications

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“…The nding of this study indicated more than half of them (54.9%) had a good treatment outcome. The rate of poor treatment outcome in this study was 45.1% which is higher than the study done in China and Turkey but in agreement with the study done in Pakistan and lower than the study that was done in South Africa [10,11,12,13]. The inconsistencies of these ndings may be related to differences in patient monitoring mechanism, the difference in the referral system, awareness of the patients about the disease condition, and its treatment and difference in the structure of the health system.…”

Section: Discussionsupporting

confidence: 88%

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Multi-Drug Resistant Tuberculosis Treatment Outcome and Associated Factors in Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study

Alemu¹,

Amogne²,

Berhe³

2020

Preprint

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BackgroundDrug-resistant tuberculosis continues to be a public health threat around the globe especially in developing countries. In 2018, the number of new cases of rifampicin-resistant tuberculosis was half a million and about 78% of them had multi-drug resistant tuberculosis. In Ethiopia, the overall proportion of multi-drug resistant tuberculosis was 11.6%. The latest treatment outcome data for people with multi-drug resistant tuberculosis show a global treatment success rate of 56%. Therefore, this study was aimed at assessing multi-drug resistant tuberculosis treatment outcomes and associated factors at St. Peter Specialized Hospital, Ethiopia, 2019. MethodsA retrospective cross-sectional study was done. A total of 384 patient medical charts selected by simple random sampling method were reviewed. The data was collected using a checklist from the patients’ medical charts. The collected data were analyzed with SPSS version 23 computer software package. Summary statistics of a given data for each variable were calculated. A logistic regression model was used to measure the association between the outcome and the predictor variable. Statistical significance was declared at p-value<0.05. Direction and strength of association were expressed using OR and 95% CI. ResultFrom a total of 384 patients, the majority of 245(63.8%) of the study subjects were females. The rate of poor treatment outcome was 173(45.1%). Male patients and patients in the age category of 39-60 years were less likely to have poor treatment outcome compared to female patients and patients in the age category of 18-38 years (AOR = 0.43, 95%CI (0.19, 0.10) and (AOR = 0.28, 95%CI (0.15, 0.52) respectively. Patients with a history of second-line TB drug resistance are more likely to have poor treatment outcomes (AOR = 3.81, 95%CI (1.84, 7.91). Poor treatment outcome was higher among patients with longer treatment duration (AOR = 3.23, 95%CI (1.82, 5.74) compared to patients with short treatment duration. ConclusionThe proportion of poor treatment outcome in patients with multi-drug resistant tuberculosis was high. Therefore, a concerted effort should be done at all levels to improve the treatment outcome of the MDR-TB.

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Section: Discussionsupporting

confidence: 88%

“…In this study, it was found that male patients were less likely to have poor treatment outcomes than female patients. This nding contradicts the study done in South Africa and India in which male patients were predictors of the poor treatment outcome [11,14]. This may be due to differences in socio-cultural in uences.…”

Section: Discussioncontrasting

confidence: 66%

Multi-Drug Resistant Tuberculosis Treatment Outcome and Associated Factors in Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study

Alemu¹,

Amogne²,

Berhe³

2020

Preprint

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“…All 48 included studies were published between 1996 and 2016 with a median population of 235 (range 60–1768) (Tables 1 and 2 ). The majority (71.4%) of studies were retrospective cohorts 10 – 13 , 15 , 28 , 34 , 44 , 46 , 48 – 50 , 54 – 57 , 59 – 61 , 63 , 65 – 71 , 73 , 74 , 76 – 79 , 81 , 82 , while 26.5% of studies were prospective cohorts 14 , 43 , 45 , 47 , 51 – 53 , 58 , 62 , 64 , 75 , 80 and one study was case-control in design 72 . There were no relevant RCTs that met our inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

“… 49 USA RC 9 83 N/A 53 (0.64) 57 (0.69) 24 (0.29) 83 (1) N/A Elliott et al . 50 South Africa RC 9 272 N/A 135 (0.50) 131 (0.48) N/A 27 (0.10) N/A Vashakidze et al . 51 Georgia PC 8 75 30 (15–54) 47 (0.63) 12 (0.16) 71 (0.95) 24 (0.32) N/A Kuaban et al .…”

Section: Resultsmentioning

confidence: 99%

“…There were 34 studies with 14,106 participants reporting outcomes in people living with HIV (PLWH) compared with people without HIV infection (Fig. 2a ) 11 – 15 , 43 – 45 , 47 – 50 , 52 – 57 , 59 – 61 , 63 – 69 , 72 , 76 , 78 , 79 , 81 , 82 . The proportion of study participants that were PLWH varied from 0.6 to 76%.…”

Section: Resultsmentioning

confidence: 99%

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Comorbidities and treatment outcomes in multidrug resistant tuberculosis: a systematic review and meta-analysis

Samuels

Sood

Campbell

et al. 2018

Sci Rep

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Little is known about the impact of comorbidities on multidrug resistant (MDR) and extensively drug resistant (XDR) tuberculosis (TB) treatment outcomes. We aimed to examine the effect of human immunodeficiency virus (HIV), diabetes, chronic kidney disease (CKD), alcohol misuse, and smoking on MDR/XDRTB treatment outcomes. We searched MEDLINE, EMBASE, Cochrane Central Registrar and Cochrane Database of Systematic Reviews as per PRISMA guidelines. Eligible studies were identified and treatment outcome data were extracted. We performed a meta-analysis to generate a pooled relative risk (RR) for unsuccessful outcome in MDR/XDRTB treatment by co-morbidity. From 2457 studies identified, 48 reported on 18,257 participants, which were included in the final analysis. Median study population was 235 (range 60–1768). Pooled RR of unsuccessful outcome was higher in people living with HIV (RR = 1.41 [95%CI: 1.15–1.73]) and in people with alcohol misuse (RR = 1.45 [95%CI: 1.21–1.74]). Outcomes were similar in people with diabetes or in people that smoked. Data was insufficient to examine outcomes in exclusive XDRTB or CKD cohorts. In this systematic review and meta-analysis, alcohol misuse and HIV were associated with higher pooled OR of an unsuccessful outcome in MDR/XDRTB treatment. Further research is required to understand the role of comorbidities in driving unsuccessful treatment outcomes.

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Drug-Resistant Tuberculosis and HIV

Auld

Gandhi

Brust

2019

HIV and Tuberculosis

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Factors affecting treatment outcomes in drug-resistant tuberculosis cases in the Northern Cape, South Africa

Cited by 16 publications

References 6 publications

Multi-Drug Resistant Tuberculosis Treatment Outcome and Associated Factors in Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study

Multi-Drug Resistant Tuberculosis Treatment Outcome and Associated Factors in Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study

Comorbidities and treatment outcomes in multidrug resistant tuberculosis: a systematic review and meta-analysis

Drug-Resistant Tuberculosis and HIV

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