Egyptian Journal of Chest Disease and Tuberculosis (Jan 2017)

Evaluation of treatment failure outcome and its predictors among pulmonary tuberculosis patients

  • Mohamed El-Shabrawy,
  • Dalia A. El-Shafei

DOI
https://doi.org/10.1016/j.ejcdt.2015.11.002
Journal volume & issue
Vol. 66, no. 1
pp. 145 – 152

Abstract

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Background: Picking up tuberculosis (TB) treatment failure cases and its determinants is urgently needed in resource-limited developing countries. This work shows incidence and probable leading factors of TB treatment failure among patients who were managed by a TB control program. Aim and objectives: This study aims to promote the TB control program at the ministry of health and population (MOHP) chest hospitals, Sharkia Governorate with the following objectives: (1) Determine the incidence of TB treatment failure. (2) Assess probable factors of TB treatment failure. Patients and methods: A retrospective cohort study was carried out at MOHP chest hospitals, Sharkia Governorate. The study sample included all registered TB patients (n =480) during the study period (2013–2014). There were 30 TB patients (Failed cases) with a positive sputum smear after 5 months of treatment (Group 1). Cured cases were 384 TB patients whose sputum smear was positive at the beginning of the treatment but became smear-negative at the end of treatment and on at least one previous occasion (Group 2). Both groups were compared to evaluate leading factors of treatment failure. Results: Of the 480 TB patients registered during the study period (2013–2014), the incidence of treatment failure was 6.25%. Treatment failure cases were significantly more likely to have: positive sputum smears at 2 months of TB treatment (p < 0.01), cavities on the baseline chest radiograph (P < 0.01), extensive disease on the baseline chest radiograph (P < 0.001). Also, retreatment case (P < 0.01) and CAT 11 treatment category were (p < 0.001). Conclusion: This study showed that the treatment failure rate in our locality is relatively high. Positive sputum smear at 2 months of TB treatment, radiological findings and retreatment patients were found to be predictors of TB treatment failure that should be recognized early and closely followed up.

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