Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan

Introduction: Tuberculosis (TB), a curable and preventable infectious disease, becomes difficult to treat if resistance against most effective and tolerable first line anti-TB drugs is developed. The objective of the present study was to evaluate the treatment outcomes and predictors of poor outcome...

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Main Authors: Massud, Asif, Khan, Amer Hayat, Syed Azhar, Syed Sulaiman, Ahmad, Nafees, Shafqat, Muhammad, Long, Chiau Ming *
Format: Article
Language:English
Published: PLOS 2023
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Online Access:http://eprints.sunway.edu.my/2708/1/Long%20Chiau%20Ming_Unsuccessful%20treatment%20outcome%20and%20associated%20risk%20factors.pdf
http://eprints.sunway.edu.my/2708/
https://doi.org/10.1371/journal.pone.0287966
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spelling my.sunway.eprints.27082024-07-01T01:35:39Z http://eprints.sunway.edu.my/2708/ Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan Massud, Asif Khan, Amer Hayat Syed Azhar, Syed Sulaiman Ahmad, Nafees Shafqat, Muhammad Long, Chiau Ming * QR Microbiology RA Public aspects of medicine RC Internal medicine RM Therapeutics. Pharmacology Introduction: Tuberculosis (TB), a curable and preventable infectious disease, becomes difficult to treat if resistance against most effective and tolerable first line anti-TB drugs is developed. The objective of the present study was to evaluate the treatment outcomes and predictors of poor outcomes among drug-resistant tuberculosis (DR-TB) patients treated at a programmatic management unit of drug resistant tuberculosis (PMDT) unit, Punjab, Pakistan. Methods: This prospective observational study was conducted at a a PMDT unit in Multan, Punjab, Pakistan. A total of 271 eligible culture positive DR-TB patients enrolled for treatment at the study site between January 2016 and May 2017 were followed till their treatment outcomes were recorded. World Health Organization's (WHO) defined criteria was used for categorizing treatment outcomes. The outcomes of cured and treatment completed were collectively placed as successful outcomes, while death, lost to follow-up (LTFU) and treatment failure were grouped as unsuccessful outcomes. Multivariable binary logistic regression analysis was employed for getting predictors of unsuccessful treatment outcomes. A p-value <0.05 was considered statistically significant. Results: Of the 271 DR-TB patients analysed, nearly half (51.3%) were males. The patient's (Mean ± SD) age was 36.75 ± 15.69 years. A total of 69% patients achieved successful outcomes with 185 (68.2%) patients being cured and 2 (0.7%) completed therapy. Of the remaining 84 patients with unsuccessful outcomes, 48 (17.7%) died, 2 (0.7%) were declared treatment failure, 34 (12.5%) were loss to follow up. After adjusting for confounders, patients' age > 50 years (OR 2.149 (1.005-4.592) with p-value 0.048 and baseline lung cavitation (OR 7.798 (3.82-15.919) with p-value <0.001 were significantly associated with unsuccessful treatment outcomes. Conclusions: The treatment success rate (69%) in the current study participants was below the target set by WHO (>75%). Paying special attention and timely intervention in patients with high risk of unsuccessful treatment outcomes may help in improving treatment outcomes at the study site. PLOS 2023 Article PeerReviewed text en cc_by_4 http://eprints.sunway.edu.my/2708/1/Long%20Chiau%20Ming_Unsuccessful%20treatment%20outcome%20and%20associated%20risk%20factors.pdf Massud, Asif and Khan, Amer Hayat and Syed Azhar, Syed Sulaiman and Ahmad, Nafees and Shafqat, Muhammad and Long, Chiau Ming * (2023) Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan. PLOS ONE, 18 (8). ISSN 1932-6203 https://doi.org/10.1371/journal.pone.0287966 10.1371/journal.pone.0287966
institution Sunway University
building Sunway Campus Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Sunway University
content_source Sunway Institutional Repository
url_provider http://eprints.sunway.edu.my/
language English
topic QR Microbiology
RA Public aspects of medicine
RC Internal medicine
RM Therapeutics. Pharmacology
spellingShingle QR Microbiology
RA Public aspects of medicine
RC Internal medicine
RM Therapeutics. Pharmacology
Massud, Asif
Khan, Amer Hayat
Syed Azhar, Syed Sulaiman
Ahmad, Nafees
Shafqat, Muhammad
Long, Chiau Ming *
Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan
description Introduction: Tuberculosis (TB), a curable and preventable infectious disease, becomes difficult to treat if resistance against most effective and tolerable first line anti-TB drugs is developed. The objective of the present study was to evaluate the treatment outcomes and predictors of poor outcomes among drug-resistant tuberculosis (DR-TB) patients treated at a programmatic management unit of drug resistant tuberculosis (PMDT) unit, Punjab, Pakistan. Methods: This prospective observational study was conducted at a a PMDT unit in Multan, Punjab, Pakistan. A total of 271 eligible culture positive DR-TB patients enrolled for treatment at the study site between January 2016 and May 2017 were followed till their treatment outcomes were recorded. World Health Organization's (WHO) defined criteria was used for categorizing treatment outcomes. The outcomes of cured and treatment completed were collectively placed as successful outcomes, while death, lost to follow-up (LTFU) and treatment failure were grouped as unsuccessful outcomes. Multivariable binary logistic regression analysis was employed for getting predictors of unsuccessful treatment outcomes. A p-value <0.05 was considered statistically significant. Results: Of the 271 DR-TB patients analysed, nearly half (51.3%) were males. The patient's (Mean ± SD) age was 36.75 ± 15.69 years. A total of 69% patients achieved successful outcomes with 185 (68.2%) patients being cured and 2 (0.7%) completed therapy. Of the remaining 84 patients with unsuccessful outcomes, 48 (17.7%) died, 2 (0.7%) were declared treatment failure, 34 (12.5%) were loss to follow up. After adjusting for confounders, patients' age > 50 years (OR 2.149 (1.005-4.592) with p-value 0.048 and baseline lung cavitation (OR 7.798 (3.82-15.919) with p-value <0.001 were significantly associated with unsuccessful treatment outcomes. Conclusions: The treatment success rate (69%) in the current study participants was below the target set by WHO (>75%). Paying special attention and timely intervention in patients with high risk of unsuccessful treatment outcomes may help in improving treatment outcomes at the study site.
format Article
author Massud, Asif
Khan, Amer Hayat
Syed Azhar, Syed Sulaiman
Ahmad, Nafees
Shafqat, Muhammad
Long, Chiau Ming *
author_facet Massud, Asif
Khan, Amer Hayat
Syed Azhar, Syed Sulaiman
Ahmad, Nafees
Shafqat, Muhammad
Long, Chiau Ming *
author_sort Massud, Asif
title Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan
title_short Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan
title_full Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan
title_fullStr Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan
title_full_unstemmed Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan
title_sort unsuccessful treatment outcome and associated risk factors. a prospective study of dr-tb patients from a high burden country, pakistan
publisher PLOS
publishDate 2023
url http://eprints.sunway.edu.my/2708/1/Long%20Chiau%20Ming_Unsuccessful%20treatment%20outcome%20and%20associated%20risk%20factors.pdf
http://eprints.sunway.edu.my/2708/
https://doi.org/10.1371/journal.pone.0287966
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