Risk factors for tuberculosis treatment failure among pulmonary tuberculosis patients in four health regions of Burkina Faso, 2009: case control study

Abstract

IntroductionIn Burkina Faso, the tuberculosis (TB) treatment failure rate increased from 2.5% in 2000 to 8.3% in 2006. The risk factors for TB treatment failure in the country are not well known. The study aims to determine the risk factors for treatment failure among pulmonary tuberculosis patients in four health region of Burkina Faso and to recommend appropriate interventions.MethodsA case control study was conducted among pulmonary TB patients who began TB treatment in 2009. A case was any patient who remained smear-positive at fifth month of TB treatment and a control was a patient who tested smear-negative at fifth month of treatment. A structured questionnaire was administered to one hundred cases and one hundred controls to collect information on exposure factors. Odds ratio were calculated using bivariate and multivariate analysis to determine the association between exposures and outcome.ResultsMultivariate analysis showed that independent risk factors for TB treatment failure were fail to take TB drugs for more than 14 consecutive days (OR = 18.53; 95% CI:4.56 - 75.22), sputum smear-positive at two months of treatment (OR = 11.52; 95%CI:5.18-25.60), existence of comorbidity (OR = 5.74; 95%CI:1.69-19.44), and use of traditional medicines or herbs (OR = 2.97; 95%CI:1.12-7.85).ConclusionEarly identification of patients with the above risk factors for intense case management will improve TB treatment outcome. Patient with smear positive at 2ndnd month of treatment require more intense follow-up, and involving traditional healers who provide traditional medicines or herbs in the educational programme on TB are required. The national referral laboratory capacity needs to be strengthened to do drug susceptibility testing and routine drug monitoring on cases of non conversion at 2nd month of treatment.

Predictors of Adverse TB Treatment Outcome among TB/HIV Patients Compared with Non-HIV Patients in the Greater Accra Regional Hospital from 2008 to 2016

“…The reasons for the adverse treatment outcome may be due to immunosuppression [19], drug interactions between rifampicin a major anti-TB drug and some antiretroviral agents [20,21], suboptimal drug concentrations of anti-TB drugs [22], and a malabsorption of the anti-TB drugs [23]. Also, late diagnosis of HIV [24], alternation of the clinical manifestation of TB [22,25], lack of a rapid and sensitive TB diagnostic test [26,27], and unavailability/inaccessibility of antiretroviral therapy [28] may be the cause of the adverse treatment outcomes.…”

The impact of rural residence and HIV infection on poor tuberculosis treatment outcomes in a large urban hospital: a retrospective cohort analysis

“…There may be differences in causes and risk factors for death, loss to follow-up or treatment failure that we may not have captured in our analysis, as we grouped the different sub-categories comprising poor treatment outcome as one. Risk factors for treatment failure reported from previous studies include drug resistance, severity of disease, co-morbidities, positive culture at 2 months [ 52 , 53 ]; while low socio-economic status, poor adherence, poor access to health care, substance abuse, fear of stigma, lack of social support, and anti-TB side effects have been implicated in treatment default. [ 27 , 28 ] However, risk factors for different poor treatment outcomes have also been shown to overlap.…”

Implementing TB control in a rural, resource-limited setting: the stop-TB Italia project in Senegal

“…The main finding of the present study is that the sequential interventions realized at HCD leaded to more favourable treatment outcomes and lower mortality rate compared to 2012 and compared to other LIC [ 16 ].While the TB treatment regimen was the same throughout the study period, cured and treatment completed rate markedly improved, as confirmed by high degree of smear negativity at the first microbiological follow up compared to other LIC settings [ 17 , 18 ]. Additionally, AFB testing and AFB conversion rate at 2 and 5 months follow up did not differ in reason of the study period, further supporting improvement of retention in care.…”