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Do retreatment tuberculosis patients need special treatment response follow-up beyond the standard regimen? A finding of five-year retrospective study in a pastoralist setting
13th World Congress on Infection Prevention and Control
Fentabil Getnet, Henok Seleshi, Wubareg Seifu and Abere Shiferaw Alemu
Background: Treatment outcomes serve as proxy measures of the quality of tuberculosis treatment. Hence, assessment of treatment outcomes is essential to evaluate the effectiveness of Directly Observed Therapy-Short course program in controlling the disease, and reducing treatment failure, death and default. Objective: The objective of this study was to assess tuberculosis treatment outcomes and predictors of unsuccessful treatment outcome in Ethiopian Somali region, September 2009 to August 2014. Methods: A retrospective review of five years data was conducted to evaluate the treatment outcomes of 1378 randomly selected tuberculosis patients treated in Kharamara, Dege-habour and Gode hospitals. We extracted data on socio-demographics, HIV Sero-status, tuberculosis type, treatment outcome and year using a prepared checklist. Tuberculosis treatment outcomes were categorized into successful (cured/completed) and unsuccessful (died/failed/default) according to the national tuberculosis guideline. Data was entered using EpiData 3.1 and analyzed using SPSS 20. Chi-square test (Ï?2) and logistic regression model were used to reveal the predictors of unsuccessful treatment outcome at Pâ?¤0.05 significance level. Result: Out of all, majorities were male (59.1%), pulmonary smear negative (49.2%) and new cases (90.6%), and HIV coinfection rate was 4.6%. The median age was 26 years. The overall treatment success rate was 86.8% [84.9%-88.5%], however, 4.8%, 7.6% and 0.7% of patients died, defaulted and failed to cure respectively. Treatment success rate fluctuated across the years and ranged from 76.9% to 94% [p<0.001]. The odds of death/failure [AOR=2.4; 95% CI=1.4â??3.9], and pulmonary smear positivity [AOR=2.3; 95% CI=1.6-3.5] were considerably higher among retreatment patients compared to new counterparts. Treatment success rate had no significant difference between age groups, genders, tuberculosis types and HIV status (P>0.05). Conclusion: This study revealed that the overall tuberculosis treatment success rate has realized the global target for 20112015. However, it does not guarantee its continuity as the trend showed that adverse treatment outcomes might unpredictably occur. Therefore, continual effort to effectively execute DOTS should be strengthened and special follow-up mechanism should be in place to monitor the treatment response of retreatment tuberculosis cases.
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