Mariem Ben Hmida1, Houda Ben Ayed1, Makram Koubaa2, Maissa Ben Jmaa3, Maroua Trigui3, Fatma Hammemi2, Tarak Ben Jmaa2, Fatma Smaoui2, Habib Feki4, Jamel Damak5, Mounir Ben Jemaa2. 1. MD, Preventive Medicine and Hospital Hygiene Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia. 2. MD, Infectious Diseases Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia. 3. MD, Community Health and Epidemiology Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia. 4. MD, Preventive Medicine and Hospital Hygiene Department and, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia. 5. MD, Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia.
Abstract
INTRODUCTION: Tuberculosis (TB) is a communicable disease common worldwide. Influencing factors in TB outcomes include socio-demographics, as well as disease-related and treatment-related factors. This study aimed to analyze the prevalence trends of unsuccessful treatment outcomes in Southern Tunisia during 1995-2016 and to identify their risk factors. METHODS: This was a retrospective study including all notified cases from the tuberculosis center reporting registers in Southern Tunisia between 1995 and 2016. RESULTS: Overall, 2771 TB cases were notified. Unsuccessful treatment outcomes were noted in 196 cases (7%). Unsuccessful treatment outcome was associated with male gender (OR=1.4; p=0.023), elderly status (≥60 years, OR=2.3; p<0.001), joints and bones site (OR=2.2; p=0.002) as well as meningeal involvement (OR=2.4; p=0.023). Lymph node (OR=0.4; p<0.001) and therapy duration ≥6 months (OR=0.003; p<0.001) were statistically associated with lower rate of unsuccessful outcome. Multivariate regression analysis showed that elderly status (AOR=2.3; p<0.001), meningeal involvement (AOR=2.2; p<0.027) as well as bone and joints involvements (AOR=2; p=0.027) were independently associated with unsuccessful outcome. Trends analysis showed that the case-fatality rate significantly increased from 1995 to 2016 (Rho=0.4; p=0.032). CONCLUSIONS: The high prevalence of unsuccessful outcome suggested important inadequacies in the TB program. An effective strategy to improve therapeutic education of patients with TB is therefore urgently needed. GERMS.
INTRODUCTION: Tuberculosis (TB) is a communicable disease common worldwide. Influencing factors in TB outcomes include socio-demographics, as well as disease-related and treatment-related factors. This study aimed to analyze the prevalence trends of unsuccessful treatment outcomes in Southern Tunisia during 1995-2016 and to identify their risk factors. METHODS: This was a retrospective study including all notified cases from the tuberculosis center reporting registers in Southern Tunisia between 1995 and 2016. RESULTS: Overall, 2771 TB cases were notified. Unsuccessful treatment outcomes were noted in 196 cases (7%). Unsuccessful treatment outcome was associated with male gender (OR=1.4; p=0.023), elderly status (≥60 years, OR=2.3; p<0.001), joints and bones site (OR=2.2; p=0.002) as well as meningeal involvement (OR=2.4; p=0.023). Lymph node (OR=0.4; p<0.001) and therapy duration ≥6 months (OR=0.003; p<0.001) were statistically associated with lower rate of unsuccessful outcome. Multivariate regression analysis showed that elderly status (AOR=2.3; p<0.001), meningeal involvement (AOR=2.2; p<0.027) as well as bone and joints involvements (AOR=2; p=0.027) were independently associated with unsuccessful outcome. Trends analysis showed that the case-fatality rate significantly increased from 1995 to 2016 (Rho=0.4; p=0.032). CONCLUSIONS: The high prevalence of unsuccessful outcome suggested important inadequacies in the TB program. An effective strategy to improve therapeutic education of patients with TB is therefore urgently needed. GERMS.
Authors: A Jaiswal; V Singh; J A Ogden; J D H Porter; P P Sharma; R Sarin; V K Arora; R C Jain Journal: Trop Med Int Health Date: 2003-07 Impact factor: 2.622
Authors: Kelly E Dooley; Ouafae Lahlou; Iraqi Ghali; Janine Knudsen; My Driss Elmessaoudi; Imad Cherkaoui; Rajae El Aouad Journal: BMC Public Health Date: 2011-02-28 Impact factor: 3.295