I Lucenko1, V Riekstina2, J Perevoscikovs1, D Mozgis3, M Khogali4, J Gadoev5, P de Colombani6, A M V Kumar7. 1. Centre for Disease Prevention and Control of Latvia, Riga, Latvia. 2. Riga East Clinical University Hospital, Centre of Tuberculosis and Lung Diseases, Riga, Latvia. 3. Centre for Disease Prevention and Control of Latvia, Riga, Latvia ; Riga Stradins University, Riga, Latvia. 4. Medical Department, Operational Research Unit, Médecins Sans Frontières (MSF), Operational Centre Brussels, MSF-Luxembourg, Luxembourg. 5. World Health Organization (WHO) Country Office, Tashkent, Uzbekistan. 6. WHO Regional Office for Europe, Copenhagen, Denmark. 7. International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India.
Abstract
SETTING: Latvia, an Eastern European country with a high burden of tuberculosis (TB). OBJECTIVE: To describe treatment outcomes among new drug-susceptible TB patients and assess the association of treatment outcomes with selected social determinants and risk factors. DESIGN: A retrospective cohort study of patients aged ⩾15 years registered during 2006-2010, with a review of records in the National Tuberculosis Registry. RESULTS: Of 2476 patients, 1704 (69%) were male; the median age was 42 years. About two thirds of patients were unemployed or retired, 7% were human immunodeficiency virus (HIV) positive and 35% had a history of alcohol use. Treatment success was achieved in 2167 (88%) patients. Older age, unemployment, HIV infection and alcohol use were found to be independently associated with unsuccessful treatment (death, loss to follow-up, failure, transfer out and other). For many variables, including HIV infection, diabetes mellitus and tobacco use, it was not possible to distinguish between 'not recorded' and 'not present' in the registry. CONCLUSION: The treatment success rate among new drug-susceptible TB patients exceeded the 85% global target for TB control. Additional attention and support is required for most vulnerable patients, such as those who are unemployed or retired, HIV infected and alcohol users. The National TB Registry should be revised to improve definitions and staff should be trained for proper data collection and recording.
SETTING: Latvia, an Eastern European country with a high burden of tuberculosis (TB). OBJECTIVE: To describe treatment outcomes among new drug-susceptible TB patients and assess the association of treatment outcomes with selected social determinants and risk factors. DESIGN: A retrospective cohort study of patients aged ⩾15 years registered during 2006-2010, with a review of records in the National Tuberculosis Registry. RESULTS: Of 2476 patients, 1704 (69%) were male; the median age was 42 years. About two thirds of patients were unemployed or retired, 7% were human immunodeficiency virus (HIV) positive and 35% had a history of alcohol use. Treatment success was achieved in 2167 (88%) patients. Older age, unemployment, HIV infection and alcohol use were found to be independently associated with unsuccessful treatment (death, loss to follow-up, failure, transfer out and other). For many variables, including HIV infection, diabetes mellitus and tobacco use, it was not possible to distinguish between 'not recorded' and 'not present' in the registry. CONCLUSION: The treatment success rate among new drug-susceptible TB patients exceeded the 85% global target for TB control. Additional attention and support is required for most vulnerable patients, such as those who are unemployed or retired, HIV infected and alcohol users. The National TB Registry should be revised to improve definitions and staff should be trained for proper data collection and recording.
Entities:
Keywords:
SORT IT; risk factors; social determinants; unsuccessful treatment
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