A Nakanwagi-Mukwaya1, A J Reid2, P I Fujiwara3, F Mugabe4, R J Kosgei5, K Tayler-Smith2, W Kizito6, M Joloba7. 1. International Union Against Tuberculosis and Lung Disease, Kampala, Uganda. 2. Médecins Sans Frontières (MSF), Operational Centre Brussels, MSF Luxembourg, Luxembourg. 3. International Union Against Tuberculosis and Lung Disease, Paris, France. 4. National Tuberculosis and Leprosy Control Programme, Ministry of Health, Kampala, Uganda. 5. Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya. 6. MSF Operation Centre Brussels, Kenya Mission, Brussels, Belgium. 7. National Tuberculosis Reference Laboratory, Ministry of Health, Kampala, Uganda.
Abstract
SETTING: Three regional referral hospitals in Uganda with a high burden of tuberculosis (TB) and human immunodeficiency virus (HIV) cases. OBJECTIVE: To determine the treatment outcomes of TB retreatment cases and factors influencing these outcomes. DESIGN: A retrospective cohort study of routinely collected National Tuberculosis Programme data between 1 January 2009 and 31 December 2010. RESULTS: The study included 331 retreatment patients (68% males), with a median age of 36 years, 93 (28%) of whom were relapse smear-positive, 21 (6%) treatment after failure, 159 (48%) return after loss to follow-up, 26 (8%) relapse smear-negative and 32 (10%) relapse cases with no smear performed. Treatment success rates for all categories of retreatment cases ranged between 28% and 54%. Relapse smear-positive (P = 0.002) and treatment after failure (P = 0.038) cases were less likely to have a successful treatment outcome. Only 32% of the retreatment cases received a Category II treatment regimen; there was no difference in treatment success among patients who received Category II or Category I treatment regimens (P = 0.73). CONCLUSION: Management of TB retreatment cases and treatment success for all categories in three referral hospitals in Uganda was poor. Relapse smear-positive or treatment after failure cases were less likely to have a successful treatment outcome.
SETTING: Three regional referral hospitals in Uganda with a high burden of tuberculosis (TB) and human immunodeficiency virus (HIV) cases. OBJECTIVE: To determine the treatment outcomes of TB retreatment cases and factors influencing these outcomes. DESIGN: A retrospective cohort study of routinely collected National Tuberculosis Programme data between 1 January 2009 and 31 December 2010. RESULTS: The study included 331 retreatment patients (68% males), with a median age of 36 years, 93 (28%) of whom were relapse smear-positive, 21 (6%) treatment after failure, 159 (48%) return after loss to follow-up, 26 (8%) relapse smear-negative and 32 (10%) relapse cases with no smear performed. Treatment success rates for all categories of retreatment cases ranged between 28% and 54%. Relapse smear-positive (P = 0.002) and treatment after failure (P = 0.038) cases were less likely to have a successful treatment outcome. Only 32% of the retreatment cases received a Category II treatment regimen; there was no difference in treatment success among patients who received Category II or Category I treatment regimens (P = 0.73). CONCLUSION: Management of TB retreatment cases and treatment success for all categories in three referral hospitals in Uganda was poor. Relapse smear-positive or treatment after failure cases were less likely to have a successful treatment outcome.
Entities:
Keywords:
ART; NTP; TB-HIV; laboratory; operational research
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