Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study

Abstract

BackgroundTB is one of the main health priorities in Uzbekistan and relatively high rates of unfavorable treatment outcomes have recently been reported. This requires closer analysis to explain the reasons and recommend interventions to improve the situation. Thus, by using countrywide data this study sought to determine trends in unfavorable outcomes (lost-to-follow-ups, deaths and treatment failures) and describe their associations with socio-demographic and clinical factors.MethodA countrywide retrospective cohort study of all new and previously treated TB patients registered in the National Tuberculosis programme between January 2006 and December 2010.ResultsAmong 107,380 registered patients, 67% were adults, with smaller proportions of children (10%), adolescents (4%) and elderly patients (19%). Sixty per cent were male, 66% lived in rural areas, 1% were HIV-infected and 1% had a history of imprisonment. Pulmonary TB (PTB) was present in 77%, of which 43% were smear-positive and 53% were smear-negative. Overall, 83% of patients were successfully treated, 6% died, 6% were lost-to-follow-up, 3% failed treatment and 2% transferred out. Factors associated with death included being above 55 years of age, HIV-positive, sputum smear positive, previously treated, jobless and living in certain provinces. Factors associated with lost-to-follow-up were being male, previously treated, jobless, living in an urban area, and living in certain provinces. Having smear-positive PTB, being an adolescent, being urban population, being HIV-negative, previously treated, jobless and residing in particular provinces were associated with treatment failure.ConclusionOverall, 83% treatment success rate was achieved. However, our study findings highlight the need to improve TB services for certain vulnerable groups and in specific areas of the country. They also emphasize the need to develop unified monitoring and evaluation tools for drug-susceptible and drug-resistant TB, and call for better TB surveillance and coordination between provinces and neighbouring countries.

Treatment outcomes of tuberculosis patients in nigist Eleni Mohammed general hospital, hosanna, southern nations, nationalities and peoples region, Ethiopia: a five year (June 2009 to August 2014) retrospective study

“…This study was consistent with the finding in Uzbekistan (60%) [16], Turkey (65%) [17], and at Mizan-Aman general hospital (57.2%) [15]. These studies reported an outweighed disease proportion of male patients over female patients.…”

“…And this finding was almost similar with the study finding conducted in Uzbekistan. In this study, pulmonary TB (PTB) was present in 77%, of which 43% were smear-positive and 53% were smear-negative [16], with the study finding conducted at Mizan- Aman general hospital (51.05%) [15], and This finding was also supported with the study finding conducted in Kwekwe district, Zimbabwe. In this study 42.4% of patients were with pulmonary tuberculosis and 8.2% of patients were with extra pulmonary tuberculosis.…”

Mortality in children diagnosed with tuberculosis: a systematic review and meta-analysis

“…The 31 included papers 10–40 comprised 35 datasets (one paper contained five separate datasets 19 ), representing 82,436 children diagnosed with tuberculosis, of whom 9,273 died (Table 1). Six studies were from the pre-treatment era, seven from the middle era, and 18 from the recent era; studies were from multiple geographic regions (Figure 2).…”

Risk factors for unfavourable treatment outcome among new smear-positive pulmonary tuberculosis cases in China

“…A 5-year study in Uzbekistan reported that the urban population was at risk for treatment failure and LTFU. 15 Potential reasons could include MDR-TB, which could be more frequent among urban than rural TB patients, and is associated with more medical resources in urban areas, which may lead to incomplete treatment. 3,16 We found that those with an unknown DOT provider were more likely to be lost to follow-up, die or have a failed treatment outcome.…”