Treatment outcomes of patients with tuberculosis in war affected region of Khyber Pakhtunkhwa, Pakistan

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background: Globally, tuberculosis (TB) remains the leading cause of death from a single infectious disease. TB treatment outcome is an indicator for the effectiveness of a national TB control program. This study aimed to assess treatment outcomes of TB patients and its determinants in Batkhela, Khyber Pakhtunkhwa, Pakistan. Methods: A retrospective cohort study was designed using all TB patients who were enrolled at District Head Quarter (DHQ) Hospital Batkhela, Pakistan, from January 2011 to December 2014. A binary logistic regression models were used to identify factors associated with successful TB treatment outcomes defined as the sum of cure and completed treatment. Results: A total of 515 TB patients were registered, of which 237 (46%) were males and 278 (53.98%) females. Of all patients, 234 (45.44%) were cured and 210 (40.77%) completed treatment. The overall treatment success rate was 444 (86.21%). Age 0-20 years (adjusted odds ratio, AOR= 3.47; 95% confidence interval, CI)= 1.54-7.81; P= 0.003), smear-positive pulmonary TB (AOR)= 3.58; 95% CI= 1.89-6.78; P= &lt;0.001), treatment category (AOR= 4.71; 95% CI= 1.17-18.97; P= 0.029), and year of enrollment 2012 (AOR= 6.26; 95% CI= 2.52-15.59; P= &lt;0.001) were significantly associated with successful treatment outcome. Conclusions: The overall treatment success rate is satisfactory but still need to be improved to achieve the international targeted treatment outcome. Type of TB, age, treatment category, and year of enrollment were significantly associated with successful treatment outcomes.</jats:p>

Treatment Outcomes Among Notified Pulmonary Tuberculosis Cases in 67 Refugee Health Facilities in the Eastern Africa-IGAD Region: Historical Cohort, 2014-2017

“…Specific association with unsuccessful outcome among patients with BCPTB was observed among male gender and with CDPTB among previously treated TB patients. The former risk was consistent with findings in [8,[47][48][49] while the latter risk agreed with [8,32]. This could be related to misclassification of patient category or choice of wrong regimen or drug quality among previously treated and higher social interaction outside home, mobility from place to place by male population.…”

Determinants of tuberculosis treatment outcomes in Asia and Africa

“…Internal factors consist of 11 determinants from within the TB patient, namely age, gender, education, HIV status, TB location, treatment category, alcohol consumption, drug use, smoking, type of ARB (Acid Resistant Bacteria), and comorbidities (Ahmad et al, 2020;Atif et al, 2014;Babalik et al, 2014;Banerjee et al, 2020;DesJardin et al, 2020;García-Basteiro et al, 2016;Habte et al, 2020;Khazaei et al, 2016;Mohammadzadeh et al, 2016;Mulogo et al, 2017;Muluye et al, 2018;Mundra et al, 2019;Ogbudebe et al, 2018;Oladimeji et al, 2021;Sadana et al, 2020;Sahyog et al, 2018;Son et al, 2021;Tesema et al, 2020;Tetteh et al, 2018;Umeokonkwo et al, 2020;Wen et al, 2018). 13 articles described age as an internal factor for TB treatment outcomes (Ahmad et al, 2020;Atif et al, 2014;Babalik et al, 2014;Habte et al, 2020;Mundra et al, 2019;Ogbudebe et al, 2018;Oladimeji et al, 2021;Sadana et al, 2020;Son et al, 2021;Tesema et al, 2020;Tetteh et al, 2018;Umeokonkwo et al, 2020;Wen et al, 2018). The likelihood of a successful treatment outcome was higher among patients aged 15-24 years, compared to patients younger than 14 years (Tesema et al, 2020), and over 61 years (Ahmad et al, 2020;Habte et al, 2020).…”

“…13 articles described age as an internal factor for TB treatment outcomes (Ahmad et al, 2020;Atif et al, 2014;Babalik et al, 2014;Habte et al, 2020;Mundra et al, 2019;Ogbudebe et al, 2018;Oladimeji et al, 2021;Sadana et al, 2020;Son et al, 2021;Tesema et al, 2020;Tetteh et al, 2018;Umeokonkwo et al, 2020;Wen et al, 2018). The likelihood of a successful treatment outcome was higher among patients aged 15-24 years, compared to patients younger than 14 years (Tesema et al, 2020), and over 61 years (Ahmad et al, 2020;Habte et al, 2020). The determinants of TB treatment outcomes can be seen in Table 2.…”

“…The location of TB as a determinant of treatment outcome was identified by eight studies. One study reported a higher probability of successful treatment outcomes in smear-positive PTB patients than in extrapulmonary TB patients (Ahmad et al, 2020). However, seven studies argue otherwise (Atif et al, 2014;Mundra et al, 2019;Oladimeji et al, 2021;Sadana et al, 2020;Son et al, 2021;Tetteh et al, 2018;Wen et al, 2018).…”

“…For this reason, WHO recommends that treatment outcomes be evaluated annually. The monitoring of treatment outcomes provides evidence to assess the effectiveness of TB control programs (Ahmad et al, 2020).…”