Patient predictors of poor drug sensitive tuberculosis treatment outcomes in Kyiv Oblast, Ukraine.
Omowunmi AibanaAndrej SlavuckijMariya BachmahaViatcheslav KrasiukNatasha RybakTimothy P FlaniganVasyl PetrenkoMegan B MurrayPublished in: F1000Research (2017)
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 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%) defaulted. 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. Alcohol abuse (OR 1.81; 95% CI 0.93 - 3.55; p 0.08) and smear positivity (OR 1.75; 95% CI 1.03 - 2.97; p 0.04) were 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.
Keyphrases
- newly diagnosed
- end stage renal disease
- hiv positive
- mycobacterium tuberculosis
- chronic kidney disease
- case report
- type diabetes
- emergency department
- antiretroviral therapy
- pulmonary hypertension
- pulmonary tuberculosis
- stem cells
- bone marrow
- men who have sex with men
- clinical practice
- human immunodeficiency virus
- mesenchymal stem cells
- hiv infected
- hiv aids
- deep learning
- adipose tissue
- weight loss
- skeletal muscle
- smoking cessation
- alcohol consumption