Unsuccessful treatment outcome and associated factors among smear-positive pulmonary tuberculosis patients in Kepong district, Kuala Lumpur, Malaysia

Abstract

PurposeThe purpose of this study was to assess tuberculosis (TB) treatment outcomes among new smear-positive pulmonary tuberculosis (PTB) patients and identify the risk factors of unsuccessful treatment outcomes in Kepong district, Kuala Lumpur, Malaysia.Design/methodology/approachA retrospective cohort study was conducted using registry-based data from the Tuberculosis Information System (TBIS) between 2014 and 2018. Simple random sampling was used to select 734 males and 380 females from the TBIS registry. Smear-positive PTB patient's sociodemographic, clinical and behavioral characteristics were extracted and analyzed. Logistic regression was used to find the possible independent risk factors for unsuccessful treatment outcomes.FindingsThe treatment success rate was 77.20% (n = 860) which was still below the target set by the WHO (>90%). In total, 254 patients showed an unsuccessful treatment outcome: 106 died, 99 defaulted, 47 not evaluated and 2 showed treatment failure. Unsuccessful treatment outcome was significantly associated with older age, male gender, non-citizen, unemployment and being HIV positive.Originality/valueThe study focuses on all these contributing factors of unsuccessful treatment outcome for a better risk assessment and stratification of TB patients and identify effective surveillance and management strategies to strengthen the control programs of tuberculosis in Kepong district.

Tuberculosis Treatment Outcome in Patients with TB-HIV Coinfection in Kuala Lumpur, Malaysia

“…The present study demonstrated that non-Malaysians had higher odds of having unsuccessful TB treatment outcome, but it was not statistically significant; thus, it was not included as a determinant in this study. This is in concordance with another study performed in Malaysia [ 26 , 28 ]. The small number of non-Malaysian patients with TB-HIV could have contributed to the nonsignificant findings of both studies.…”

“…Here, lack of formal education, being unemployed, and low household income were significantly associated with unsuccessful treatment outcome, compared to having received formal education, being employed, and high household income. These findings are in concordance with other studies that show that people with low socioeconomic backgrounds tend to have a higher risk of poorer TB treatment outcome [ 26 , 35 , 36 ]. The risk of developing TB increases among people with low socioeconomic backgrounds, as they usually live in areas with poor ventilation, have poor knowledge and behavioural practices regarding the disease itself, and are malnourished, which may lead to low immunity [ 36 ].…”

“…is is in concordance with another study performed in Malaysia [26,28]. e small number of non-Malaysian patients with TB-HIV could have contributed to the nonsignificant findings of both studies.…”

“…However, datasets used for analysis in this study are not publicly available due to some concern, in which it contained health information which could compromise the privacy of research participants. Details on TBIS also have been cited in few other studies related to TB in Malaysia [24][25][26].…”

Clinical, laboratory and radiological associations with extending of the intensive phase of treatment in patients with first diagnosed infiltrative pulmonary tuberculosis

“…It is often longer and requires more careful monitoring of the course of the disease [10]. The occurrence of relapses is associated with the development of resistance, which dictates the need for strict adherence to the treatment regimen for a first diagnosed tuberculosis process (FDTB) and careful monitoring of the dynamics of the disease to prevent recurrent course [11].…”