Drug-susceptible tuberculosis treatment success and associated factors in Ethiopia from 2005 to 2017: a systematic review and meta-analysis

Seid, Mohammed Assen; Ayalew, Mohammed Biset; Muche, Esileman Abdela; Gebreyohannes, Eyob Alemayehu; Abegaz, Tadesse Melaku

doi:10.1136/bmjopen-2018-022111

Cited by 28 publications

(30 citation statements)

References 55 publications

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“…The pooled TSR in the present study is less than the 86% reported in a previous systematic review and meta-analysis of 34 studies in Ethiopia 73. However, one should be cautious in comparing our data with that of Ethiopia due to differences in eligibility criteria.…”

Section: Discussioncontrasting

confidence: 79%

Treatment success rate among adult pulmonary tuberculosis patients in sub-Saharan Africa: a systematic review and meta-analysis

et al. 2019

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ObjectivesTo summarise treatment success rate (TSR) among adult bacteriologically confirmed pulmonary tuberculosis (BC-PTB) patients in sub-Saharan Africa (SSA).DesignWe searched MEDLINE, EMBASE, Google Scholar and Web of Science electronic databases for eligible studies published in the decade between 1 July 2008 and 30 June 2018. Two independent reviewers extracted data and disagreements were resolved by consensus with a third reviewer. We used random-effects model to pool TSR in Stata V.15, and presented results in a forest plot with 95% CIs and predictive intervals. We assessed heterogeneity with Cochrane’s (Q) test and quantified with I-squared values. We checked publication bias with funnel plots and Egger’s test. We performed subgroup, meta-regression, sensitivity and cumulative meta-analyses.SettingSSA.ParticipantsAdults 15 years and older, new and retreatment BC-PTB patients.OutcomesTSR measured as the proportion of smear-positive TB cases registered under directly observed therapy in a given year that successfully completed treatment, either with bacteriologic evidence of success (cured) or without (treatment completed).Results31 studies (2 cross-sectional, 1 case–control, 17 retrospective cohort, 6 prospective cohort and 5 randomised controlled trials) involving 18 194 participants were meta-analysed. 28 of the studies had good quality data. Egger’s test indicated no publication bias, rather small study effect. The pooled TSR was 76.2% (95% CI 72.5% to 79.8%; 95% prediction interval, 50.0% to 90.0%, I2statistics=96.9%). No single study influenced the meta-analytical results or conclusions. Between 2008 and 2018, a gradual but steady decline in TSR occurred in SSA but without statistically significant time trend variation (p=0.444). The optimum TSR of 90% was not achieved.ConclusionOver the past decade, TSR was heterogeneous and suboptimal in SSA, suggesting context and country-specific strategies are needed to end the TB epidemic.PROSPERO registration numberCRD42018099151.

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Section: Discussioncontrasting

confidence: 79%

Treatment success rate among adult pulmonary tuberculosis patients in sub-Saharan Africa: a systematic review and meta-analysis

et al. 2019

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“…A study in Europe (2005), reported a pooled estimate of successful outcomes of 74.4% (95% CI 71.0–77.9%), this lower estimate than the one reported in this review could be attributed to the fact that the studies analyzed in this work are prior to 2005 [158]. While, another study in Ethiopia, reported a global success rate of combined TB treatment of 86% (with a 95% CI: 83%-88%), higher than our estimate of successful treatment [159]. To XDR and MDR TB a review published in 2017 reported pooled treatment success of 26% and 60% respectively, which is not different from our results[160].…”

Section: Discussioncontrasting

confidence: 64%

Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis

et al. 2019

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ObjectiveTo produce pooled estimates of the global results of tuberculosis (TB) treatment and analyze the predictive factors of successful TB treatment.MethodsStudies published between 2014 and 2019 that reported the results of the treatment of pulmonary TB and the factors that influenced these results. The quality of the studies was evaluated according to the Newcastle-Ottawa quality assessment scale. A random effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (CI). This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) in February 2019 under number CRD42019121512.ResultsA total of 151 studies met the criteria for inclusion in this review. The success rate for the treatment of drug-sensitive TB in adults was 80.1% (95% CI: 78.4–81.7). America had the lowest treatment success rate, 75.9% (95% CI: 73.8–77.9), and Oceania had the highest, 83.9% (95% CI: 75.2–91.0). In children, the success rate was 84.8% (95% CI: 77.7–90.7); in patients coinfected with HIV, it was 71.0% (95% CI: 63.7–77.8), in patients with multidrug-resistant TB, it was 58.4% (95% CI: 51.4–64.6), in patients with and extensively drug-resistant TB it was 27.1% (12.7–44.5). Patients with negative sputum smears two months after treatment were almost three times more likely to be successfully treated (OR 2.7; 1.5–4.8), whereas patients younger than 65 years (OR 2.0; 1.7–2.4), nondrinkers (OR 2.0; 1.6–2.4) and HIV-negative patients (OR 1.9; 1.6–2.5 3) were two times more likely to be successfully treated.ConclusionThe success of TB treatment at the global level was good, but was still below the defined threshold of 85%. Factors such as age, sex, alcohol consumption, smoking, lack of sputum conversion at two months of treatment and HIV affected the success of TB treatment.

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“…between the study settings, difference in sample size and variation of study period. The success rate in the current study was also lower than the pooled estimate of TB treatment success rate in Ethiopia (86%) and WHO 2030 international target of �90% [4,26]. According to this study, age of the patient is one of the significant predictor for unsuccessful treatment outcome.…”

Section: Plos Onecontrasting

confidence: 60%

Determinants of tuberculosis treatment outcome under directly observed treatment short courses in Adama City, Ethiopia

et al. 2020

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Background Tuberculosis (TB) is a leading cause of death among infectious agents, ranking above HIV/ AIDS. Though much effort has been done, Ethiopia remained one of those countries which share the greatest burden of TB. Evaluating the TB treatment outcome is one method of TB control measures. Therefore, the aim of the current study was to assess TB treatment outcome and its determinants under directly observed treatment short courses in Adama City, Central Ethiopia. Method An institutional based cross sectional study was conducted in all public and private health facilities of Adama city from March 1 st 2016 to December 31 st , 2016. The data were entered and analyzed by using SPSS version 21.0 statistical software. The results were presented using descriptive statistics. Univariate and multivariate logistic regression model was used to evaluate the potential determinants of unsuccessful treatment outcome. Results Among 281 patients evaluated, 90(32%) were cured, 137(48.8%) have completed the treatment, 4(1.4%) were treatment failure, 36(12.8%) were lost to follow up, and 14 (5%) died. The overall treatment success rate was 80.8%. Age 15-24 (Adjusted odds ratio (AOR): 4.97; 95% Confidence interval (CI): 1.13-21.90), distance less than 5 kilometers from treatment center (AOR: 3.1; 95% CI: 1.42-6.77), being seronegative for human immunodeficiency virus (HIV) (AOR: 20.38; 95% CI: 7.80-53.24) were associated with successful TB treatment outcome. Conclusion The treatment outcome of all forms tuberculosis patients in Adama city was unsatisfactory when referred with the national pooled estimate of 86% and WHO 2030 international target

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Drug-susceptible tuberculosis treatment success and associated factors in Ethiopia from 2005 to 2017: a systematic review and meta-analysis

Cited by 28 publications

References 55 publications

Treatment success rate among adult pulmonary tuberculosis patients in sub-Saharan Africa: a systematic review and meta-analysis

Treatment success rate among adult pulmonary tuberculosis patients in sub-Saharan Africa: a systematic review and meta-analysis

Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis

Determinants of tuberculosis treatment outcome under directly observed treatment short courses in Adama City, Ethiopia

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