Faculty, Staff and Student Publications
Publication Date
1-1-2017
Journal
F1000Research
Abstract
Background: Ukraine has high rates of poor treatment outcomes among drug sensitive tuberculosis (DSTB) patients, while global treatment success rates for DSTB remain high.
We evaluated baseline patient factors as predictors of poor DSTB treatment outcomes.
Methods: We conducted a retrospective analysis of new drug sensitive pulmonary TB patients treated in Kyiv Oblast, Ukraine between November 2012 and October 2014. We defined good treatment outcomes as cure or completion and poor outcomes as death, default (lost to follow up) or treatment failure. We performed logistic regression analyses, using routine program data, to identify baseline patient factors associated with poor outcomes.
Results: Among 302 patients, 193 (63.9%) experienced good treatment outcomes while 39 (12.9%) failed treatment, 34 (11.3%) died, and 30 (9.9%) were lost to follow up. In the multivariate analysis, HIV positive patients on anti-retroviral therapy (ART) [OR 3.50; 95% CI 1.46 – 8.42; p 0.005] or without ART (OR 4.12; 95% CI 1.36 – 12.43; p 0.01) were at increased risk of poor outcomes. Smear positivity (OR 1.75; 95% CI 1.03 - 2.97; p 0.04) was also associated with poor treatment outcomes.
Conclusions: High rates of poor outcomes among patients with newly diagnosed drug sensitive TB in Kyiv Oblast, Ukraine highlight the urgent need for programmatic interventions, especially aimed at patients with the highest risk of poor outcomes.
Keywords
tuberculosis, drug sensitive, treatment outcomes, patient predictors, HIV, HIV-TB coinfection, Ukraine, Eastern Europe
DOI
10.12688/f1000research.12687.3
PMID
31839924
PMCID
PMC6859782
PubMedCentral® Posted Date
November 2019
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes