Recurrence of tuberculosis among patients following treatment completion in eight provinces of Vietnam: A nested case-control study

Bestrashniy, Jessica; Nguyen, Viet Nhung; Nguyen, Thi; Pham, Thi Lieu; Nguyen, Thu Anh; Pham, Duc Cuong; Nghiem, Le Phuong Hoa; Le, Thi Ngoc Anh; Nguyen, Binh Hoa; Nguyen, Kim Cuong; Nguyen, Hieu Duy; Buu, Tran N.; Le, Thanh Nhan Nguyen; Nguyễn, Việt Hùng; Dinh, Ngoc Sy; Britton, Warwick J.; Marks, Guy B.; Fox, Greg J.

doi:10.1016/j.ijid.2018.06.013

Cited by 28 publications

(22 citation statements)

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“…In this study, though treatment outcome as per WHO definition is found to be good, the use of retrospective secondary data may affect the success rate because it was totally dependent on the documented data in the TB DOTS registration logbook and cannot control the outcome. As we didn't have available smear test results, the vast majority of successful cases (70.2%) were categorized as "treatment completed" and which is actually reported as risk for treatment relapse [31,32]. Being a single-center study, the results may not be generalized to all other health centers situated in Addis Ababa.…”

Section: Discussionmentioning

confidence: 91%

Tuberculosis treatment outcome among patients treated in public primary healthcare facility, Addis Ababa, Ethiopia: a retrospective study

2020

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Background: Despite the availability of effective drugs, tuberculosis remains a major public health problem that predominantly affects low-and middle-income countries. This study aimed to assess tuberculosis treatment outcomes among patients treated at one of the primary health care levels in Addis Ababa, Ethiopia. Methods: An institutional-based retrospective cross-sectional study was conducted at a tuberculosis clinic in public primary healthcare facility. The study populations were all patients with tuberculosis who had been completed their treatment course in the center from July 2014 to July 2018. After getting Ethical clearance and permission from the health center, trained data collectors working in the center were recruited. The collected data were checked for completeness every day by the principal investigators. Data were edited, cleaned, and analyzed using SPSS version 25. Descriptive statistics were used to summarize the data while multinomial logistic regression was employed to explore associations among variables of interest, and p < 0.05 was considered as statistically significant. Results: A total of 352 patients with tuberculosis were included for the study with a median age of 25 years which ranged from 1 to79 year. Most (36.4%) participants were in the age group of 15 to 24 years. The majority (38.8%) of patients had extrapulmonary tuberculosis, 11.9% of them were HIV positive and only two had family history of tuberculosis. Regarding treatment outcome, 238(67.6%) completed the treatment, 95(27%) cured and the rest were unsuccessful treatment outcomes 19(5.4%) either died, defaulted or treatment failed. The odds ratio for cured in relation to unsuccessful treatment outcome was found to be significantly higher in HIV negative patients (AOR = 6.1; 95%CI 2.1-13.9) compared with those patients tested positive for HIV. While patients with smearpositive pulmonary tuberculosis (AOR = 10.5, 95% CI 5.36-16.31) were significantly associated with the odds of having complete treatment cure as compared to patients with extrapulmonary tuberculosis. Similarly being HIV positive and extrapulmonary tuberculosis were predicting factors for unsuccessful treatment compared with their counterparts. Conclusions: The finding of the present study showed that successful tuberculosis treatment outcome was found to be optimal.

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Section: Discussionmentioning

confidence: 91%

Tuberculosis treatment outcome among patients treated in public primary healthcare facility, Addis Ababa, Ethiopia: a retrospective study

2020

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“…In addition to age, the other predictive factor for recurrence among TB patients treated in Serveis Clínics was resistance to at least one anti-TB drug. In China and Vietnam, an association was found between MDR and TB recurrence [37,38], while TB recurrences among South African miners were associated with anti-TB drug resistance [39]. In Uzbekistan, resistance to treatment was also found to substantially contribute to TB recurrences [40].…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have analyzed the effect of a prior TB episode. A case-control study conducted in Vietnam concluded that one of the factors associated with recurrence was having reported a prior history of TB [38]. A previous study conducted in Barcelona reported that a history of TB treatment before study inclusion was a risk factor for recurrence [14].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis recurrences and predictive factors in a vulnerable population in Catalonia

Brugueras

Molina²,

Casas³

et al. 2020

PLoS ONE

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Background Patients with a history of tuberculosis (TB) have a high probability of recurrence because long-term cure is not always maintained in successfully treated patients. The aim of this study was to identify the probability of TB recurrence and its predictive factors in a cohort of socially vulnerable patients who completed treatment in the TB referral center in Catalonia, which acts as the center for patients with social and health problems. Methods This retrospective open cohort study included all patients diagnosed with TB who were admitted and successfully treated in Serveis Clínics between 2000 and 2016 and who remained disease-free for a minimum of 1 year after treatment completion. We calculated the incidence density of TB recurrences per person-years of follow-up. We also estimated the cumulative incidence of TB recurrence at 1, 2, 5, and 10 years of follow-up. Bivariate analysis was conducted using Kaplan-Meier curves. Multivariate analysis was conducted using Cox regression. Hazard ratios (HR) were calculated with their 95% confidence intervals (95%CI). Results There were 839 patients and 24 recurrences (2.9%), representing 0.49 per 100 personyears. The probability of a recurrence was 0.63% at 1 year of follow-up, 1.35% at 2 years, and 3.69% at 5 years. The multivariate analysis showed that the predictive factors of recurrence were age older than 34 years (aHR = 3.90; CI = 1.06-14.34 at age 35-45 years and aHR = 3.88; CI = 1.02-14.80 at age >45 years) and resistance to at least one anti-TB drug (aHR = 2.91; CI = 1.11-7.65).

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“…In observational datasets from Russia and the USA, this association extends to the development of drug resistance [51,52], although in simulations it has not been consistently proven [53]. Recurrence of TB disease among pulmonary TB patients was higher with worse implementation in both the Yemen and Vietnam [54,55].…”

Section: Suboptimal Implementationmentioning

confidence: 99%

All nonadherence is equal but is some more equal than others? Tuberculosis in the digital era

et al. 2020

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Adherence to treatment for tuberculosis (TB) has been a concern for many decades, resulting in the World Health Organization's recommendation of the direct observation of treatment in the 1990s. Recent advances in digital adherence technologies (DATs) have renewed discussion on how to best address nonadherence, as well as offering important information on dose-by-dose adherence patterns and their variability between countries and settings. Previous studies have largely focussed on percentage thresholds to delineate sufficient adherence, but this is misleading and limited, given the complex and dynamic nature of adherence over the treatment course. Instead, we apply a standardised taxonomy – as adopted by the international adherence community – to dose-by-dose medication-taking data, which divides missed doses into 1) late/noninitiation (starting treatment later than expected/not starting), 2) discontinuation (ending treatment early), and 3) suboptimal implementation (intermittent missed doses). Using this taxonomy, we can consider the implications of different forms of nonadherence for intervention and regimen design. For example, can treatment regimens be adapted to increase the “forgiveness” of common patterns of suboptimal implementation to protect against treatment failure and the development of drug resistance? Is it reasonable to treat all missed doses of treatment as equally problematic and equally common when deploying DATs? Can DAT data be used to indicate the patients that need enhanced levels of support during their treatment course? Critically, we pinpoint key areas where knowledge regarding treatment adherence is sparse and impeding scientific progress.

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Recurrence of tuberculosis among patients following treatment completion in eight provinces of Vietnam: A nested case-control study

Abstract: Index disease treatment history is a leading determinant of relapse among patients with TB in Vietnam. Further research is required to identify interventions that will reduce the risk of recurrent disease and enhance its early detection within high-risk populations.

Cited by 28 publications

References 17 publications

Tuberculosis treatment outcome among patients treated in public primary healthcare facility, Addis Ababa, Ethiopia: a retrospective study

Tuberculosis treatment outcome among patients treated in public primary healthcare facility, Addis Ababa, Ethiopia: a retrospective study

Tuberculosis recurrences and predictive factors in a vulnerable population in Catalonia

All nonadherence is equal but is some more equal than others? Tuberculosis in the digital era

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