Predictors of Mortality and Loss to Follow-up among Drug-Resistant Tuberculosis Patients in Oromia Hospitals, Ethiopia: A Retrospective Follow-up Study

2021 ◽  
Keyword(s):  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Loss To Follow Up ◽  
Tuberculosis Patients ◽  
Predictors Of Mortality ◽  
Follow Up Study ◽  
Resistant Tuberculosis

scholarly journals Trends, Characteristics and Treatment Outcomes of Patients with Drug-Resistant Tuberculosis in Uzbekistan: 2013–2018

2021 ◽  
Vol 18 (9) ◽  
pp. 4663
Author(s):  
Khasan Safaev ◽  
Nargiza Parpieva ◽  
Irina Liverko ◽  
Sharofiddin Yuldashev ◽  
Kostyantyn Dumchev ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
National Level ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Loss To Follow Up ◽  
Resistant Tuberculosis ◽  
Mdr Tb

Uzbekistan has a high burden of drug-resistant tuberculosis (TB). Although conventional treatment for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) has been available since 2013, there has been no systematic documentation about its use and effectiveness. We therefore documented at national level the trends, characteristics, and outcomes of patients with drug-resistant TB enrolled for treatment from 2013–2018 and assessed risk factors for unfavorable treatment outcomes (death, failure, loss to follow-up, treatment continuation, change to XDR-TB regimen) in patients treated in Tashkent city from 2016–2017. This was a cohort study using secondary aggregate and individual patient data. Between 2013 and 2018, MDR-TB numbers were stable between 2347 and 2653 per annum, while XDR-TB numbers increased from 33 to 433 per annum. At national level, treatment success (cured and treatment completed) for MDR-TB decreased annually from 63% to 57%, while treatment success for XDR-TB increased annually from 24% to 57%. On multivariable analysis, risk factors for unfavorable outcomes, death, and loss to follow-up in drug-resistant TB patients treated in Tashkent city included XDR-TB, male sex, increasing age, previous TB treatment, alcohol abuse, and associated comorbidities (cardiovascular and liver disease, diabetes, and HIV/AIDS). Reasons for these findings and programmatic implications are discussed.

scholarly journals Is One Sputum Specimen as Good as Two during Follow-Up Cultures for Monitoring Multi Drug Resistant Tuberculosis Patients in India?

PLoS ONE ◽  
2012 ◽  
Vol 7 (9) ◽  
pp. e45554 ◽  
Author(s):  
Sharath Burugina Nagaraja ◽  
Ajay M. V. Kumar ◽  
Kuldeep Singh Sachdeva ◽  
Ranjani Ramachandran ◽  
Srinath Satyanarayana ◽  
...  
Keyword(s):  
Drug Resistant ◽  
Sputum Specimen ◽  
Drug Resistant Tuberculosis ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis

scholarly journals Determinant factors for loss to follow-up in drug-resistant tuberculosis patients: the importance of psycho-social and economic aspects

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Soedarsono Soedarsono ◽  
Ni Made Mertaniasih ◽  
Tutik Kusmiati ◽  
Ariani Permatasari ◽  
Ni Njoman Juliasih ◽  
...  
Keyword(s):  
Social Support ◽  
Health Service ◽  
Economic Status ◽  
Treatment Success ◽  
Negative Attitude ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Loss To Follow Up ◽  
Resistant Tuberculosis

Abstract Background Drug-resistant tuberculosis (DR-TB) is the barrier for global TB elimination efforts with a lower treatment success rate. Loss to follow-up (LTFU) in DR-TB is a serious problem, causes mortality and morbidity for patients, and leads to wide spreading of DR-TB to their family and the wider community, as well as wasting health resources. Prevention and management of LTFU is crucial to reduce mortality, prevent further spread of DR-TB, and inhibit the development and transmission of more extensively drug-resistant strains of bacteria. A study about the factors associated with loss to follow-up is needed to develop appropriate strategies to prevent DR-TB patients become loss to follow-up. This study was conducted to identify the factors correlated with loss to follow-up in DR-TB patients, using questionnaires from the point of view of patients. Methods An observational study with a cross-sectional design was conducted. Study subjects were all DR-TB patients who have declared as treatment success and loss to follow-up from DR-TB treatment. A structured questionnaire was used to collect information by interviewing the subjects as respondents. Obtained data were analyzed potential factors correlated with loss to follow-up in DR-TB patients. Results A total of 280 subjects were included in this study. Sex, working status, income, and body mass index showed a significant difference between treatment success and loss to follow-up DR-TB patients with p-value of 0.013, 0.010, 0.007, and 0.006, respectively. In regression analysis, factors correlated with increased LTFU were negative attitude towards treatment (OR = 1.2; 95% CI = 1.1–1.3), limitation of social support (OR = 1.1; 95% CI = 1.0–1.2), dissatisfaction with health service (OR = 2.1; 95% CI = 1.5–3.0)), and limitation of economic status (OR = 1.1; 95% CI = 1.0–1.2)). Conclusions Male patients, jobless, non-regular employee, lower income, and underweight BMI were found in higher proportion in LTFU patients. Negative attitude towards treatment, limitation of social support, dissatisfaction with health service, and limitation of economic status are factors correlated with increased LTFU in DR-TB patients. Non-compliance to treatment is complex, we suggest that the involvement and support from the combination of health ministry, labor and employment ministry, and social ministry may help to resolve the complex problems of LTFU in DR-TB patients.

scholarly journals Lost to follow-up and associated factors among patients with drug resistant tuberculosis in Ethiopia: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248687
Author(s):  
Assefa Andargie ◽  
Asressie Molla ◽  
Fentaw Tadese ◽  
Segenet Zewdie
Keyword(s):  
Associated Factors ◽  
Meta Analysis ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Pooled Prevalence ◽  
Lost To Follow Up

Background One third of global antmicrobial resistance deaths are attributed to drug resistant tuberculosis. Lost to follow-up is one of the causes of the development of acquired drug resistant tuberculosis. There is a gap in nationally representative reliable information on lost to follow-up among patients with drug-resistant tuberculosis in Ethiopia. Objective To estimate the pooled prevalence and associated factors of lost to follow-up among patients with drug resistant tuberculosis in Ethiopia. Methods Observational studies searched from PubMed, HINARI and CINAHL were screened for eligibility. After assessing the quality of studies, data were extracted using a checklist. Heterogeneity was assessed using forest plot, Q and I2. The random effects meta-analysis model was employed to pull the prevalence of lost to follow-up. Sub-group analysis and meta regression were performed to identify the sources of heterogeneity. Publication bias was assessed using funnel plots with Egger’s and Begg’s tests. Sensitivity analysis was performed to assess the influence of individual studies on the overall estimate. The odds ratios were used to measure associations. Results The review was performed among 11 studies of which 9 were cohort studies. The sample sizes ranged from 90 to 612 and comprised a total of 3,510 participants. The pooled prevalence of lost to follow-up was 8.66% (95% CI, 5.01–13.14) with a high heterogeneity (I2 = 93.49%, p<0.001). Pulmonary multi-drug resistant tuberculosis patients were 50% less likely to loss from follow-up compared to extra pulmonary tuberculosis patients. Conclusion There was a high prevalence of lost to follow-up among multi-drug resistant tuberculosis patients in Ethiopia. Anatomical site of tuberculosis was a significant factor affecting lost to follow-up. Strengthening the health care system and patient education should be given a due emphasis. Registration number CRD42020153326; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=153326.

scholarly journals Extra Pulmonary Drug Resistant Tuberculosis Patients Were Less Likely to Lost From Follow-up: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Assefa Andargie ◽  
Asressie Molla ◽  
Fentaw Tadese ◽  
Segenet Zewdie
Keyword(s):  
Meta Analysis ◽  
Anatomical Site ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
Pooled Prevalence ◽  
Extra Pulmonary ◽  
Lost To Follow Up

Abstract Background: Lost to follow-up is one of the causes of the development of acquired drug resistant tuberculosis. There is a gap in nationally representative information on lost to follow-up among patients with drug-resistant tuberculosis in Ethiopia. Therefore, the objective of this study was to estimate the pooled prevalence and associated factors of lost to follow-up among patients with multi-drug resistant tuberculosis in Ethiopia.Methods: Observational studies searched from PubMed, HINARI and CINAHL were screened for eligibility. After assessing the quality of studies, data were extracted using a checklist. The forest plot, Q-statistics and I2 were used to assess heterogeneity. We employed the random effects meta-analysis model to estimate the pooled prevalence and effects. The sources of heterogeneity were investigated using sub-group analysis and meta regression. Funnel plot with Egger’s and Begg’s tests were employed to detect publication bias. Results: The review was performed among 11 studies of which 9 were cohort studies. The sample sizes ranged from 90 to 612 and comprised a total of 3,510 participants. The pooled prevalence of lost to follow-up was 8.66% (95% CI, 5.01-13.14) with a high heterogeneity (I2=93.49%, p<0.001). Pulmonary drug resistant tuberculosis patients were 50% less likely to loss from follow-up compared to extra pulmonary tuberculosis patients (OR= 0.50, 95% CI 0.27, 0.96). Conclusion: The prevalence of lost to follow-up among drug resistant tuberculosis patients in Ethiopia was substantial. Anatomical site of tuberculosis had a significant effect on lost to follow-up. Strengthening the health care system and patient education should be given a due emphasis.

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