Tuberculosis Treatment Outcomes and Factors Associated with Each of Them in a Cohort Followed Up between 2010 and 2014

Abstract

Tuberculosis treatment has undergone recent changes in Brazil. Objective. To assess whether favorable outcomes on tuberculosis therapy improved in recent years. Methods. Retrospective observational study, based on primary data of tuberculosis patients, followed at INI-FIOCRUZ, from January 2012 to December 2014. Results. The outcomes observed were as follows: cure (80%), default (14%), treatment failure (5%), and death (1%). HIV infection without antiretroviral therapy [OR 0.34 (0.15–0.79)], tuberculosis diagnosis based on sputum smear [OR 0.22 (0.07–0.74)], drug use [OR 0.22 (0.11–0.46)], and/or treatment interruption due to adverse reactions [OR 0.23 (0.08–0.67)] decreased the chance of cure. Predictors of default, that is, use of noninjecting drugs [OR 3.00 (95% CL 1.31–6.88)], treatment interruption due to adverse reactions [OR 6.30 (1.81–21.95)], low schooling [OR 2.59 (2.15–5.82)], higher age [OR 0.44 (0.23–0.82)], and female gender [OR 0.28 (0.11–0.71)], reduced the chance of treatment default. Tuberculosis diagnosis based on sputum smear [OR 7.77 (1.94–31.09)] and/or arterial hypertension [OR 4.07 (1.25–13.18)] was associated with treatment failure. Conclusion. Mortality and default were low considering the prevalence of HIV infection; however cure was not significantly increased.

Factors Associated with Unfavourable Treatment Outcomes in Patients with Tuberculosis: A 16-Year Cohort Study (2005–2020), Republic of Karakalpakstan, Uzbekistan

“…Our study found that the TB death rate among HIV-positive patients in the period under review was almost 10 times higher than in HIV-negative patients. These data agree with studies conducted in other countries [ 29 ]. WHO recommendations for country TB and HIV programs to work together on timely initiation of antiretroviral therapy (ART) can considerably decrease unfavourable treatment outcomes, especially deaths among patients with TB/HIV co-infection [ 30 , 31 ].…”

Assessment of knowledge, attitude and practice on tuberculosis among teacher trainees of Samtse College of Education, Bhutan

“…The majority of the participants mentioned that TB drugs should not be discontinued once patient feels well as it would lead to development of drug resistant TB. Defaulting treatment [ 37 , 38 ] and non-adherence [ 39 ] are the main reasons for TB treatment failure and development of drug resistant. The findings in our study correlates with an earlier study in Bhutan which reported low default cases [ 40 ].…”

Increased risk of hepatotoxicity and temporary drug withdrawal during treatment of active tuberculosis in pregnant women

“…Other studies have found higher risks of adverse treatment outcomes due to drug withdrawal, including an increase in mortality and acquired drug resistance (Pablos-Mendez et al, 1997). A retrospective study from Brazil, including both men and women, showed that discontinuation of TB treatment for 60 days or more due to adverse events, decreased the chance of cure (OR 0.23; 95% CI 0.08-0.67) (Cardoso et al, 2017). In a Chinese prospective study of both men and women, the patients with hepatotoxicity because of anti-TB drugs had a 9.3-fold increased risk of unsuccessful TB treatment outcomes and a 2.1-fold increased risk of prolonged intensive treatment phase (Shang et al, 2011).…”