Tuberculosis retreatment outcomes and associated factors: a mixed-methods study from Puducherry, India

Velavan, A.; Purty, Anil J; Shringarpure, Kalpita; Sagili, Karuna D.; Mishra, Ankita; Selvaraj, Kalaiselvi; Manikandan, M.; Saravanan, V.

doi:10.5588/pha.18.0038

Cited by 12 publications

(31 citation statements)

References 9 publications

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“…This result is explained by the fact that patients followed up at SMIT have often been referred for atypical clinical pictures or consulted after a long therapeutic period. The predominance of pulmonary localization reported in our series is comparable to the results of Velavan [7] and Valin N [8]. These data show that regardless of the type of tuberculosis, the lungs remain the main portal of entry.…”

Section: Resultssupporting

confidence: 91%

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

Cissé¹,

Fortes²,

AminataMassaly³

et al. 2019

J Infect Dis Epidemiol

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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.

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Section: Resultssupporting

confidence: 91%

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

Cissé¹,

Fortes²,

AminataMassaly³

et al. 2019

J Infect Dis Epidemiol

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“…The impact on the care cascade has documented either challenge at the health workforce or the organizational level with a broader scope. The most contributing factors that were documented at the health workforce level are overburdened manpower working in the TB program, 20 inappropriate referral by private providers, 17 , 22 unqualified practitioners considered as informal providers, 19 delay in referral for TB diagnosis from the private facilities, 10 , 19 , 26 inadequate trained manpower, 27 misinterpretation of provisional diagnosis, 26 etc. In addition to it, the health-care staff attitude and behaviour 21 , 24 , 26 and poor counseling capacities 18 , 21 were also found to be a risk factor such as health-care providers not explaining problems of stopping the medicine, or inappropriate attitude of the providers leading to the misconception or delays in care-seeking.…”

Section: Resultsmentioning

confidence: 99%

“…Some of the social factors, which are more context-specific, should be addressed to improve the TB cascade and other public health challenges. Factors like stigma, 19 , 20 , 38 discrimination, 20 lack of family to the social support, 27 , 29 , 32 negative counselling by family/friends 10 also contribute largely to the care cascade. Table 2 summarizes all the factors (both system-side and demand-side) as evidenced in the synthesis contributing to the care cascade.…”

Section: Resultsmentioning

confidence: 99%

“…At the individual level, diverse factors were documented. On a broader scale, poverty, 17,32 unemployment and financial constraints, 10,17,[24][25][26][27]31,33,38 migration, 26 illiteracy 40 stands as major factors, as documented in most of the studies. Followed which, awareness about the disease/ availability of services, 17,21,24,25,28,40 ignorance or selftreating symptoms, 10,18,20,21,24,26,28 myths/wrong beliefs, shame/confidentiality issues 21 found to be significant contributors.…”

Section: Demand-side Contributing Factors (Individual/social)mentioning

confidence: 99%

“…providers, 19 delay in referral for TB diagnosis from the private facilities, 10,19,26 inadequate trained manpower, 27 misinterpretation of provisional diagnosis, 26 etc. In addition to it, the health-care staff attitude and behaviour 21,24,26 and poor counseling capacities 18,21 were also found to be a risk factor such as health-care providers not explaining problems of stopping the medicine, or inappropriate attitude of the providers leading to the misconception or delays in care-seeking.…”

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confidence: 99%

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Contributing Factors in the Tuberculosis Care Cascade in India: A Systematic Literature Review

Yasobant¹,

Bhavsar²,

Kalpana³

et al. 2021

RMHP

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Tuberculosis (TB) care cascade is a recently evolved care model for patient retention across the sequential stages of care for a successful treatment outcome. The care cascade is multi-folded and complex in setting where the health system is reforming for its resilience. India, one of the countries with the highest burden of tuberculosis mortality and morbidity, is not an exception to this complexity. With the diverse challenges in the Indian health system and societal diversity, it is essential to understand the factors contributing to this TB care cascade. Thus, this study aims to map all the contributing factors to the TB care cascade in India. Further, it also captures the different patterns of factors explored so far in different countries’ regions. This systematic literature review was conducted between October 2020 and February 2021 in India using PubMed databases, Web of Science, and Google Scholar. Two reviewers extracted the data from eligible studies to summarize and tabulate important findings. Data were extracted and tabulated for study design, location of the study, type of TB patients, methodological approach, system side challenges, and demand-side challenges in the study’s findings. Out of 692 initial hits from the literature search, 28 studies were finally included to synthesize evidence in this review as per the inclusion and exclusion criteria. This review provides an insight into different factors such as the system-side (health workforce, institutional) and the demand-side (individual, societal) contributing towards the care cascade. The prime factors reflected in most of the studies were socio-economic condition, disease awareness, myths/beliefs, addictions among the demand-side factors and accessibility, the attitude of the healthcare staff, delay in referral for diagnosis among the system-side factors. The accountability for addressing these diverse factors is recommended to close the gaps in the TB care cascade.

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Undernutrition increases the risk of unsuccessful treatment outcomes of patients with tuberculosis in Ethiopia: A multicenter retrospective cohort study

Wagnew,

Alene,

Kelly

et al. 2024

Journal of Infection

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Tuberculosis retreatment outcomes and associated factors: a mixed-methods study from Puducherry, India

Cited by 12 publications

References 9 publications

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

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

Contributing Factors in the Tuberculosis Care Cascade in India: A Systematic Literature Review

Undernutrition increases the risk of unsuccessful treatment outcomes of patients with tuberculosis in Ethiopia: A multicenter retrospective cohort study

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