Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia

Kefale, Adane Teshome; Anagaw, Yeniewa Kerie

doi:10.2147/ijgm.s135305

Cited by 20 publications

(29 citation statements)

References 18 publications

(29 reference statements)

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“…But, the other studies done in other parts of Ethiopia [15,20] and China [27] reported as there is no significant difference between treatment success rate and type of TB. According to studies conducted at Jinka General Hospital [21], Afar [28] and another study done by Kefale et al at Southwest Ethiopia [29]; TB/HIV co-infection was found to be a predictor for unsuccessful treatment outcome, which is similar to the present study.…”

Section: Discussionsupporting

confidence: 90%

Tuberculosis treatment outcome among patients treated in public primary healthcare facility, Addis Ababa, Ethiopia: a retrospective study

2020

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Background: Despite the availability of effective drugs, tuberculosis remains a major public health problem that predominantly affects low-and middle-income countries. This study aimed to assess tuberculosis treatment outcomes among patients treated at one of the primary health care levels in Addis Ababa, Ethiopia. Methods: An institutional-based retrospective cross-sectional study was conducted at a tuberculosis clinic in public primary healthcare facility. The study populations were all patients with tuberculosis who had been completed their treatment course in the center from July 2014 to July 2018. After getting Ethical clearance and permission from the health center, trained data collectors working in the center were recruited. The collected data were checked for completeness every day by the principal investigators. Data were edited, cleaned, and analyzed using SPSS version 25. Descriptive statistics were used to summarize the data while multinomial logistic regression was employed to explore associations among variables of interest, and p < 0.05 was considered as statistically significant. Results: A total of 352 patients with tuberculosis were included for the study with a median age of 25 years which ranged from 1 to79 year. Most (36.4%) participants were in the age group of 15 to 24 years. The majority (38.8%) of patients had extrapulmonary tuberculosis, 11.9% of them were HIV positive and only two had family history of tuberculosis. Regarding treatment outcome, 238(67.6%) completed the treatment, 95(27%) cured and the rest were unsuccessful treatment outcomes 19(5.4%) either died, defaulted or treatment failed. The odds ratio for cured in relation to unsuccessful treatment outcome was found to be significantly higher in HIV negative patients (AOR = 6.1; 95%CI 2.1-13.9) compared with those patients tested positive for HIV. While patients with smearpositive pulmonary tuberculosis (AOR = 10.5, 95% CI 5.36-16.31) were significantly associated with the odds of having complete treatment cure as compared to patients with extrapulmonary tuberculosis. Similarly being HIV positive and extrapulmonary tuberculosis were predicting factors for unsuccessful treatment compared with their counterparts. Conclusions: The finding of the present study showed that successful tuberculosis treatment outcome was found to be optimal.

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Section: Discussionsupporting

confidence: 90%

Tuberculosis treatment outcome among patients treated in public primary healthcare facility, Addis Ababa, Ethiopia: a retrospective study

2020

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“…The overall successful TB treatment outcome in this study was 78.6%. Our result is higher than that of previous studies conducted in Africa (Ethiopia 28.9% [11], 30.3% [12], 70.8% [13], Nigeria 48.8% [10], Ghana 64.0% [14] and Cameroon 60.8% [15]) and elsewhere (Malaysia 53.4% [16]). This dissimilarity might be due to the difference in number of study participants involved in the various studies.…”

Section: Discussioncontrasting

confidence: 87%

Tuberculosis treatment outcome and its associated factors among people living with HIV and AIDS in Fako Division of Cameroon

et al. 2019

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Background Tuberculosis (TB) and HIV co-infection challenges treatment and worsens the outcome of TB treatment. This study aimed to assess the outcome of TB treatment and factors facilitating treatment success among people living with HIV/AIDS in Fako Division of the South West Region of Cameroon. Methods A hospital-based retrospective cohort study was conducted by manually reviewing medical records of HIV/TB co-infected patients from January 2010 to September 2017. A structured data collection form was used to review the medical records of HIV patients co-infected with TB aged 10 years and older. Patients with incomplete files were dropped from the study. Treatment success was defined as the sum of patients who were declared cured and those who had completed treatment, as per the World Health Organization’s recommendations. Data were analyzed using Statistical Package for Social Sciences version 21. Bivariate and multivariate logistic regression model was carried out to identify factors facilitating successful TB treatment outcome. Significance was obtained through adjusted odds ratio with its 95% confidence interval and a p<0.05. Results A total of 2,986 files were reviewed but 2,928 (98.1%) were retained. Out of the 2,928 medical files of adult TB patients reviewed, 1,041 (35.6%, [95% CI 33.8%-37.3%]) were HIV/TB co-infected. The 1,041 co-infected patients had a mean age of 37.07 (SD of10.02) years and 56.3% were females. The treatment outcome of TB patients were 795(76.4%) cured, 23(2.2%) treatment completed, 99(9.5%) were lost to follow-up, 16 (1.5%) failed, 72(6.9%) died and 36(3.5%) transferred out. A successful treatment outcome was achieved in 818(78.6%,[95% CI: 76.0%–81.0%]) patients. Being a female [COR 1.61, 95% CI: 1.19–2.17, p = 0.002], receiving TB treatment in 2014 [COR 2.00, 95% CI: 1.11–3.60, p = 0.021] and 2015 [COR 2.50, 95% CI: 1.39–4.50, p = 0.002], having relapsed TB infection [COR 0.46, 95% CI: 0.23–0.93, p = 0.031], receiving ART [COR 1.95, 95% CI: 1.28–2.97, p = 0.002] and Cotrimoxazole [COR 2.03, 95% CI: 1.12–3.66, p = 0.019] were factors significantly associated with successful treatment. After adjusting for confounders, successful treatment outcome were associated with being a female [AOR 1.6; 95% CI: 1.21–2.22, p = 0.001], diagnosis of TB in 2014 [AOR 1.90; 95% CI: 1.04–3.45, p = 0.036] and 2015 [AOR 2.43; 95% CI: 1.33–4.43, p = 0.004]. Conclusion There is a high TB treatment success rate among HIV/TB co-infected patients in our setting, although below the target set by the WHO. Specific interventions aimed at enhancing patient outcomes are recommended.

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“…In relation to cohort and case–control studies, the total NOS scores ranged from 5 to 9, signifying included studies were of good quality. A score of 5 was recorded in a case–control49 and a retrospective cohort study,50 a score of 7 was found in one retrospective51 and another prospective cohort study,52 a score of 8 was found in four studies (two prospective cohort53 54 and two retrospective cohort studies,55 56 while each of the remaining 16 studies scored 9 (see online supplementary table 3). With respect to risk of bias in RCTs using the Cochrane’s collaboration tool, we found low risk of bias on the selection domain for the RCTs57–60 except in one RCT60 where it was high (see online supplementary figure 1).…”

Section: Resultsmentioning

confidence: 99%

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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Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia

Cited by 20 publications

References 18 publications

Tuberculosis treatment outcome among patients treated in public primary healthcare facility, Addis Ababa, Ethiopia: a retrospective study

Tuberculosis treatment outcome among patients treated in public primary healthcare facility, Addis Ababa, Ethiopia: a retrospective study

Tuberculosis treatment outcome and its associated factors among people living with HIV and AIDS in Fako Division of Cameroon

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

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