T Kelebi1, K C Takarinda2,3, R Commons4,5, B Sissai1, J Yowei1, M Gale4. 1. West Sepik Provincial Health Authority, Vanimo, West Sepik Province, Papua New Guinea. 2. International Union Against Tuberculosis and Lung Disease, Paris, France. 3. AIDS & TB Department, Ministry of Health and Child Care, Harare, Zimbabwe. 4. Burnet Institute, Melbourne, Victoria, Australia. 5. Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia.
Abstract
SETTING: Papua New Guinea (PNG), a low-resource country with a high tuberculosis (TB) burden. OBJECTIVE: To describe the characteristics, treatment outcomes and risk factors for unfavourable outcomes among patients registered for first-line tuberculosis (TB) treatment between 1 January 2014 and 31 December 2016 in West Sepik Province. DESIGN: This was a retrospective cohort study of routinely collected programme data. RESULTS: Of 1058 cases, 50.7% were male and 38.8% were aged <15 years; 43.1% were extrapulmonary TB cases and 280 (26.5%) were bacteriologically confirmed. No human immunodeficiency virus (HIV) status was recorded for 74.7% of cases. Of 1019 (96.3%) patients with a recorded outcome, 779 (76.4%) were favourable and 240 (23.6%) were unfavourable. On multivariable logistic regression, increasing age was associated with an increased odds of an unfavourable outcome (adjusted OR [aOR] 1.06 per every 5-year increase, 95%CI 1.02-1.11; P = 0.006) and being a retreatment case was associated with a reduced odds of an unfavourable outcome compared to new cases (aOR 0.54, 95%CI 0.31-0.93; P = 0.027). CONCLUSION: This study identified substantial gaps in TB care, including low rates of bacteriological diagnosis and HIV testing, and high rates of loss to follow-up, highlighting the need to strengthen TB control efforts, including support for new cases.
SETTING: Papua New Guinea (PNG), a low-resource country with a high tuberculosis (TB) burden. OBJECTIVE: To describe the characteristics, treatment outcomes and risk factors for unfavourable outcomes among patients registered for first-line tuberculosis (TB) treatment between 1 January 2014 and 31 December 2016 in West Sepik Province. DESIGN: This was a retrospective cohort study of routinely collected programme data. RESULTS: Of 1058 cases, 50.7% were male and 38.8% were aged <15 years; 43.1% were extrapulmonary TB cases and 280 (26.5%) were bacteriologically confirmed. No human immunodeficiency virus (HIV) status was recorded for 74.7% of cases. Of 1019 (96.3%) patients with a recorded outcome, 779 (76.4%) were favourable and 240 (23.6%) were unfavourable. On multivariable logistic regression, increasing age was associated with an increased odds of an unfavourable outcome (adjusted OR [aOR] 1.06 per every 5-year increase, 95%CI 1.02-1.11; P = 0.006) and being a retreatment case was associated with a reduced odds of an unfavourable outcome compared to new cases (aOR 0.54, 95%CI 0.31-0.93; P = 0.027). CONCLUSION: This study identified substantial gaps in TB care, including low rates of bacteriological diagnosis and HIV testing, and high rates of loss to follow-up, highlighting the need to strengthen TB control efforts, including support for new cases.
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