Predictors Of Catastrophic Costs Of Tuberculosis (TB) Among Patients Co-Affected With TB-HIV And TB-Diabetes In Bhavnagar Region, Western India

Rupani, Mihir P.; Vyas, Sheetal

doi:10.55489/njcm.130820222251

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…The TB death rate (8.7%) observed in this study was lower than the 10% target set by the TB strategic plan [29], 17.7% reported in Ethiopia [27], and 10.1% in another Ethiopian study [30]. However, it was higher than the 4.17% in a Pakistani study [31] and the 2% reported in India [26].…”

Section: Discussioncontrasting

confidence: 65%

Determinants of treatment success among drug-susceptible tuberculosis patients in Ghana: A prospective cohort study

Djochie,

Anto,

Aduele Opare-Addo

2023

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BackgroundAchieving optimal rates of success in tuberculosis treatment is vital not just for the individual patient’s well-being but also for preventing the rise of drug-resistant tuberculosis strains. Unfavourable treatment outcomes pose significant challenges for healthcare systems worldwide. Identifying the factors that determine treatment success is crucial for implementing effective interventions that enhance treatment outcomes and contribute to the eradication of the disease. As a result, this study aimed to assess tuberculosis treatment outcomes and identify factors associated with treatment success.MethodsPatients diagnosed with active tuberculosis were closely monitored from the start of their treatment until its completion from January 2021 to June 2022. A data collection tool, developed using Redcap and aligned with the study objectives, was utilized to gather demographic information, and adverse reactions to antitubercular medicines and track the treatment outcomes of the participants. The participants’ quality of life was assessed using the Short-form 12 version 2 questionnaire at baseline, as well as at the end of the second and sixth months. Logistic regression was employed to evaluate the association between various participant characteristics and treatment success, with odds ratios used to quantify the strength of the associations.ResultsAmong 378 participants, 77.3% had successful TB treatment, while 13.5% were lost to follow-up, 0.5% experienced treatment failure, and 8.7% died. Factors influencing treatment success included initial body weight, weight gain during treatment, HIV status, drug adverse reactions, and mental well-being at the beginning of treatment. Multivariate analysis showed that gaining at least 3kg during treatment and having no risk of depression at the beginning significantly increased the likelihood of successful treatment.ConclusionPatients with tuberculosis who experience compromised physical and mental health-related quality of life, encounter adverse reactions to antitubercular drugs and have concurrent HIV infection should receive close monitoring and personalized interventions to improve their chances of treatment success.

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Section: Discussioncontrasting

confidence: 65%

Determinants of treatment success among drug-susceptible tuberculosis patients in Ghana: A prospective cohort study

Djochie,

Anto,

Aduele Opare-Addo

2023

Preprint

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Cohort study on association between catastrophic costs and unfavorable tuberculosis treatment outcomes among TB-HIV and TB-diabetes comorbid patients in India

Rupani,

Vyas,

Shah

2024

BMC Public Health

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Background India grapples with an alarming burden of tuberculosis (TB), reporting 2.6 million incident cases in 2023, necessitating intensified efforts toward TB elimination. The prevalence of catastrophic costs, defined as expenses exceeding 20% of annual household income, varies widely. Our objective was to determine the association between catastrophic costs from TB-HIV and TB-diabetes care and unfavorable TB treatment outcomes. Methods We conducted a cohort study in Bhavnagar, India, from July 2019 to January 2021, involving 234 TB-HIV and 304 TB-diabetes patients. Catastrophic costs were assessed using the World Health Organization’s tool. Unfavorable TB treatment outcomes included positive results from sputum smear, nucleic acid amplification, or culture tests at treatment completion, death during treatment, or treatment cessation for a month (for drug-sensitive TB) or two months (for drug-resistant TB). Firth regression was employed to address quasi-separation issues and identify predictors. Results Among TB-HIV patients, 12% faced catastrophic costs, with 20% experiencing unfavorable TB outcomes. In this group, significant predictors included weight (OR: 0.93, 95% CI: 0.89–0.98), family type (OR: 2.5, 95% CI: 1.2–5.5), and initial hospitalization (OR: 2.6, 95% CI: 1.1–6.3). For TB-diabetes patients, 5% faced catastrophic costs, and 14% had unfavorable outcomes, with significant predictors being below the poverty line (BPL) (OR: 2.9, 95% CI: 1.5–5.9) and initial hospitalization (OR: 3.4, 95% CI: 1.1–11.1). Catastrophic cost incidence was higher in TB-HIV (12% vs. 4% in TB only) and TB-diabetes (5% vs. 4% in TB only) patients. However, catastrophic costs did not show a direct association with unfavorable outcomes in either group. Conclusions Our study found no direct association between catastrophic costs and unfavorable TB outcomes among TB-HIV/TB-diabetes patients. Instead, factors such as weight, family type, BPL status, and initial hospitalization were significant predictors. These findings underscore the importance of socio-economic conditions and initial hospitalization, advocate for enhanced support mechanisms including nutritional and financial aid, especially for BPL families. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-024-19609-0.

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Predictors Of Catastrophic Costs Of Tuberculosis (TB) Among Patients Co-Affected With TB-HIV And TB-Diabetes In Bhavnagar Region, Western India

Cited by 2 publications

References 21 publications

Determinants of treatment success among drug-susceptible tuberculosis patients in Ghana: A prospective cohort study

Determinants of treatment success among drug-susceptible tuberculosis patients in Ghana: A prospective cohort study

Cohort study on association between catastrophic costs and unfavorable tuberculosis treatment outcomes among TB-HIV and TB-diabetes comorbid patients in India

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