Tuberculosis Re-Treatment Cases and Factors Associated with Unfavourable Outcome at the Fann University Hospital of Dakar, Senegal between 2011 and 2016: A Follow-Up Study

Abstract

Introduction: The aim of our study was to describe the socio-demographic, clinical, therapeutic and evolutionary characteristics of patients admitted to tuberculosis re-treatment and managed at the The Infectious and Tropical Diseases Department (SMIT) screening and tuberculosis treatment center (TTC), to determine the factors associated with unfavourable outcome Methodology: This is a descriptive and analytical retrospective cross sectional study covering all tuberculosis re-treatment cases monitored in the service of infectious and tropical diseases in Fann from 1 January 2011 to 31 December 2016. The Epi-Info software version 7 CDC and SAS (version 9.3, Cary, NC, USA) were used for data entry and analysis. Results: We collected 83 patients as re-treatment tuberculosis cases during the study period, for an annual average of 14 cases. The average age of the patients was 42.2 years ± 13.6 years, with extremes of 16 and 77 years. There was a male predominance (66.3%) with a sex ratio of 1.96. The majority (95.2%) of our patients came from the Dakar region, 42.2% of them from the suburban area. More than two thirds (77.1%) of our patients were hospitalized. Clinically, the average weight at initiation of tuberculosis treatment was 48.1 kg ± 9.9 kg. The isolated pulmonary form accounted for 63%, followed by the multifocal form 23%. HIV seroprevalence was 73.6% and 92.9% of these patients were on cotrimoxazole chemoprophylaxis and 60.7% on ARV treatment. Relapses (61.4%) and treatment after default (36.1%) constituted the majority of the re-treatment circumstances. The unfavourable outcome was related to provenance in suburban areas and outside Dakar (AOR = 17.5; 95% CI: 3.61-85.4). Conclusion: Compliance and monitoring of retreatment cases is important to avoid TB drug resistance. It is necessary to improve the referral and counter-referral system as well as communication between the different tuberculosis treatment centers.

Tuberculosis Treatment Outcomes and Associated Factors in Benadir Somalia. A Multicenter Cohort Study

“…This is in line with many other studies, including one conducted in Eritrea that showed the same results. 29 This finding relates to the higher mortality rate in HIV patients, which is a result of their lower immune function, and the higher lost-to-follow-up rate, which is a result of the higher stigma associated with HIV.…”