High tuberculosis treatment success in Kabul, Afghanistan despite high patient transfers out.

The National Tuberculosis (TB) Institute has the highest patient transfer-out rate in Afghanistan, but the result and treatment outcome of transferred patients were unknown in 2009. This operational research investigated the characteristics and treatment outcome of all transferred-out patients living in Kabul province. We analysed the 1-year TB register of the Institute (n = 1180 cases) and visited 24 health centres to review their TB registers. The results show the transfer-out rate was 52.6%. Of the transferred cases, 58.6% were women and 61.8% pulmonary TB cases (smear-positive 70.6%). The arrival rates of transfer-out patients at health centres in Kabul province were 87.6% for both men and women. Males aged 21-40 years were the most likely to be nonarrivals (OR = 8.91; 95% CI: 1.55-66.7). Treatment success rates in female and male patients were 84.4% and 77.5% respectively and default rates were 7.8% and 18.3%. Strategies to reduce the non-arrival to health centres and treatment interruption in male patients aged 20-40 years are warranted.