Low enrollment and high treatment success in children with drug-resistant tuberculosis in Ethiopia: A ten years national retrospective cohort study

Abstract

BackgroundLimited evidence exists on the treatment outcome and factors that are associated with the duration from the initiation of treatment to death or treatment failure in children with drug resistant tuberculosis (DR-TB). Thus, we aimed to determine the proportion of treatment enrollment, status of treatment outcome and determine factors that are associated with the duration from treatment initiation to death or treatment failure in children treated for DR-TB in Ethiopia. MethodsWe conducted a retrospective cohort study in children younger than 15 years old who were treated for DR-TB from February 2009 to February 2019 in Ethiopia. We collected data on socio-demographic and clinical characteristics from clinical charts, registration books and laboratory result reports on 155 children. Proportion of enrollment to the treatment was calculated by dividing the total number of children who were receiving the treatment by the total number of DR-TB patients treated during the specified years. We used Cox proportional hazard models to determine factors that were associated with the duration from the beginning of the treatment to death or treatment failure. Data was analyzed using STATA version 14. ResultsOf the 3,478 DR-TB patients enrolled into the treatment and fulfilling our inclusion criteria during the past ten years, 155 (4.5%) were children. Of the 155 children, 75 (48.4%) completed the treatment and 51 (32.9%) were cured. Furthermore, 18 (11.6%) children were died, seven (4.5%) lost to follow up and treatment of four (2.6%) children was failed. The overall treatment success was 126 (81.3%). Age younger than 5 years old [Adjusted Hazard PLOS ONE | https://doi.

Incidence and predictors of mortality among persons receiving second-line tuberculosis treatment in sub-Saharan Africa: A meta-analysis of 43 cohort studies

“…From among the 43 studies that were included, a total of 31,525 persons receiving SLD were followed-up and 4,976 of them encountered the incidence of mortality. The study participants for four of these studies were children [32][33][34][35]; for 20 of the studies were adults [23,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]; and for 19 of the studies were both adults and children [55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73]. Methodological design for nine of the studies was prospective cohort [23, 39, 42-46, 50, 63] while it was retrospective cohort for 34 of the remaining studies [32-38, 40, 41, 47-49, 51-62, 64-73].…”

“…Moreover, two of the studies reported delays (i.e., more than a month) in initiating SLD therapy [59,61]; encounters of adverse drug events (ADEs) [40,41], and extrapulmonary involvement [34,41] as the predictors of the mortality outcome. Reports of individual studies also indicated multiple other drugs than SLD [41]; previous episode of TB [71]; previous history of failed treatment [23], and under five aged children [35] as the predictors of mortality. We combined risk ratio estimates for at least three of the studies that reported similar predictors of all-cause mortality and found its significant increases among persons receiving the SLD and with certain characteristics.…”

Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape

“…The 1051 DR-TB children notified (mainly from South Africa and the Philippines) represent <1% of the 115,000 target established by the UNHLM for 2018-2022. DR-TB in children tends to have a good outcome when appropriate care is provided (Ettehad et al, 2012;Tola et al, 2020). However, programmatic advances appear to be minimal in the top 10 HBCs and globally (Dodd et al, 2016).…”

Faktor Yang Mempengaruhi Pasien Tuberkulosis Resistan Obat Yang Tidak Memulai Pengobatan: Literature Review

“…[11] Rendahnya inisiasi pengobatan TBC RO pada anak dapat disebabkan karena infrastruktur laboratorium DST yang tidak memadai, kurangnya klinisi yang berpengalaman dalam mendeteksi penyakit, rendahnya perilaku pencarian pengobatan dalam keluarga, dan lambatnya sistem kesehatan. [13] e Faktor utama lainnya yang mempengaruhi LTFU sebelum pengobatan TBC RO adalah karena faktor ekonomi dan hilang kontak. [7], [8] Pasien yang membayar sendiri pengobatannya akan semakin rentan untuk tidak berobat TBC RO.…”