Treatment Outcomes of Patients with Tuberculosis in New York City

Bhavnani, Darlene; Lancki, Nicola; Winter, I; Macaraig, Michelle

doi:10.1097/phh.0000000000000193

Cited by 9 publications

(11 citation statements)

References 15 publications

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“…Non-adherence results in serious problems not only for the patients themselves (including development of complications, acquired drug resistance, and death), but also for communities in terms of the spread of infection [ 31 ]. In our study, male gender, foreign nationality, smear-negative PTB and EPTB, and treatment outcome reported by institutions other than public health centres were risk factors for loss to follow-up, which was consistent with previous studies [ 32 – 35 ]. The number of TB patients of foreign nationality has increased in South Korea (from 849 patients in 2010 to 2045 in 2017) [ 2 ].…”

Section: Discussionsupporting

confidence: 92%

Treatment outcomes and factors affecting treatment outcomes of new patients with tuberculosis in Busan, South Korea: a retrospective study of a citywide registry, 2014–2015

Mok

Kim

et al. 2018

BMC Infect Dis

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BackgroundThis study investigated the treatment outcomes, and factors affecting the outcomes, of new tuberculosis (TB) patients in Busan, South Korea.MethodsWe retrospectively analysed the citywide TB registry data (collected for the Korean National TB Surveillance System) of new TB patients registered in Busan from January 2014 to December 2015.ResultsA total of 4732 patients were included in this study (mean age, 52.5 ± 19.9 years; 58.4% male). The overall treatment success rate was 83.9% (cured, 20.2%; completed, 63.7%); 8.0% of patients died, and 3.6% were lost to follow-up. In multivariate analyses, a higher rate of loss to follow-up was associated with foreign nationality, registered as TB-positive at least twice, and being in Q4 (fourth quintile) or Q5 (fifth quintile) of the regional deprivation index. Conversely, a lower rate of loss to follow-up was associated with female gender, smear-positive for pulmonary TB (PTB), and the treatment outcome being reported by a public health centre. Higher mortality was associated with old age (≥ 75 years), smear-positive PTB, treatment outcome being reported by the hospital, and being registered as TB-positive twice. Lower mortality was associated with female gender, treatment outcome being reported by a public health centre or clinic, and Q5 of the regional deprivation index.ConclusionsTreatment outcomes of new TB patients were sub-optimal in Busan. TB control programs should maintain close monitoring and provide greater socioeconomic support to patients at high risk of poor treatment outcomes.

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Section: Discussionsupporting

confidence: 92%

Treatment outcomes and factors affecting treatment outcomes of new patients with tuberculosis in Busan, South Korea: a retrospective study of a citywide registry, 2014–2015

Mok

Kim

et al. 2018

BMC Infect Dis

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“…On the other hand, only 34.0% of patients completed treatment, well below the WHO target of 85%. This is much lower than the figure reported from New York city in the United States of America (91%) where factors associated with delay in treatment completion were attributed to poor communication, refusal to continue treatment and movement of patients from one site of care to another (11). Our default rate from treatment was 8.1%, versus the WHO target of 4%, and this is slightly lower than that the rate reported in a study in Nigeria (9.1%) (10), but higher than a study in India (7.2%) (12).…”

Section: Discussioncontrasting

confidence: 51%

Epidemiology of tuberculosis and evaluation of treatment outcomes in the national tuberculosis control programme, River Nile state, Sudan, 2011-2013

Elmadhoun

Noor

Bushara

et al. 2016

East Mediterr Health J

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Tuberculosis is a major health problem in Sudan, a country that carries 11-15% of the tuberculosis burden in the Eastern Mediterranean Region. This study aimed to describe the epidemiology of tuberculosis in River Nile State and to compare treatment outcomes with WHO recommended indicators. A descriptive study was conducted on data collected from records of 1221 patients registered at tuberculosis management units over the 3 years 2011-2013. The mean age of cases was 37.7 (SD 21.5) years and 65.9% were males; 76.3% were pulmonary tuberculosis and 36.9% were sputum smear-positive cases. Average values for all outcome indicators were suboptimal, notably rates of case notification (30.8 per 100 000), case detection (10.3%), treatment success (79.6%), treatment failure (3.0%), default (8.1%) and death (8.0%). Of the 264 patients tested for HIV, 3.8% were positive. Outcome indicators for the national tuberculosis control programme are lagging behind the required targets. RÉSUMÉ La tuberculose est un problème de santé majeur au Soudan où elle représente 11 à 15 % de la charge de la maladie dans la Région de la Méditerranée orientale. La présente étude avait pour objectif de décrire l'épidémiologie de la tuberculose dans l'État du Nil et de comparer les résultats du traitement à l'aide d'indicateurs recommandés par l'OMS. Une étude descriptive a été menée à partir de données extraites des dossiers de 1221 patients admis dans des unités de prise en charge de la tuberculose sur une période de trois ans (2011)(2012)(2013). L'âge moyen des cas était de 37,7 ans (ET 21,5) et 65,9 % étaient de sexe masculin ; 76,3 % étaient atteints de tuberculose pulmonaire et 36,9 % étaient des cas à frottis positifs. Les valeurs moyennes pour tous les indicateurs de résultats étaient sous-optimales, notamment les taux de notification (30,8 pour 100 000), de dépistage de cas (10,3 %), de guérison (79,6 %), d'échec thérapeutique (3,0 %), d'abandon (8,1 %) et de décès (8,0 %). Sur les 264 patients dépistés pour le VIH, 3,8 % étaient positifs. Les indicateurs de résultats pour le programme national de lutte antituberculeuse accusent un retard par rapport aux objectifs fixés. 2011-

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“…The WHO mandates successful TB treatment outcomes of greater than 90% in developing nations and lower resource settings [1]. High proportions of successful TB treatment reported in higher resource settings [2], [3] that serve TB patients from all over the world argue such goals are possible. Nonetheless, the realities of differences in public health resources to burden of TB patients can make such targets difficult to attain [4].…”

Section: Introductionmentioning

confidence: 99%

Predictors of tuberculosis treatment outcomes among a retrospective cohort in rural, Central India

Laux

Patil

2018

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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IntroductionProgrammatic design affects access to healthcare and can influence tuberculosis treatment outcomes. Potential predictors of tuberculosis treatment outcomes in one rural Indian setting were examined to improve outcomes with a focus on access to care.MethodsRoutinely collected tuberculosis treatment data from Jan Swasthya Sahyog, a community based healthcare system in rural Chhattisgarh, India were examined from 2003–2015. Predictors were analyzed for associations with death, loss to follow-up or failure in multivariable logistic regression models. The effect of distance from treatment on outcomes was graphed and Pearson's correlation coefficients (r2) calculated. Descriptive time to event analyses were performed for all deaths and loss to follow-up from January 2010 to September 2015.Results4979 patients with active TB were treated during the study period. Patients were mostly male, malnourished, diagnosed with pulmonary disease and many travelled lengthy distances. Positive treatment outcomes improved from 55% to 80% from 2003 to 2015 for all patients though positive treatment outcomes have been above 80% in the primary care setting since 2012. The annual case fatality rate was 4.4% with small yearly variation.Gender and site of treatment (primary versus secondary care facility) and also season of treatment initiation and travel time to care best predicted outcomes in both the complete model and model which included only patients with initial BMI data. No differences were found between primary and secondary care patients for initial BMI, percentage of sputum positivity among those with pulmonary disease and grade of sputum positivity among the sputum positive. Those who traveled the furthest to access care achieved the worst outcomes during the summer and, to a lesser degree, the monsoon. Distance from care was associated with treatment outcomes in a dose-response manner out to substantial distances. From 2010 to 2015, most patients who died or were lost to follow-up did so in the first week of treatment.ConclusionsThe provision of care through local facilities improves the treatment of tuberculosis in rural India. Interventions addressing death or loss to follow-up should focus on the newly diagnosed. Rural Indian physicians should be aware of how access issues affect TB treatment outcomes.

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Treatment Outcomes of Patients with Tuberculosis in New York City

Cited by 9 publications

References 15 publications

Treatment outcomes and factors affecting treatment outcomes of new patients with tuberculosis in Busan, South Korea: a retrospective study of a citywide registry, 2014–2015

Treatment outcomes and factors affecting treatment outcomes of new patients with tuberculosis in Busan, South Korea: a retrospective study of a citywide registry, 2014–2015

Epidemiology of tuberculosis and evaluation of treatment outcomes in the national tuberculosis control programme, River Nile state, Sudan, 2011-2013

Predictors of tuberculosis treatment outcomes among a retrospective cohort in rural, Central India

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