Prevalence, chronological trends and predictors of treatment outcomes among patients with tuberculosis in Southern Tunisia across two decades (1995-2016).

Autor:	Hmida MB; MD, Preventive Medicine and Hospital Hygiene Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia., Ayed HB; MD, Preventive Medicine and Hospital Hygiene Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia., Koubaa M; MD, Infectious Diseases Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia., Jmaa MB; MD, Community Health and Epidemiology Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia., Trigui M; MD, Community Health and Epidemiology Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia., Hammemi F; MD, Infectious Diseases Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia., Jmaa TB; MD, Infectious Diseases Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia., Smaoui F; MD, Infectious Diseases Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia., Feki H; MD, Preventive Medicine and Hospital Hygiene Department and, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia., Damak J; MD, Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia., Jemaa MB; MD, Infectious Diseases Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia.
Jazyk:	angličtina
Zdroj:	Germs [Germs] 2021 Jun 02; Vol. 11 (2), pp. 147-154. Date of Electronic Publication: 2021 Jun 02 (Print Publication: 2021).
DOI:	10.18683/germs.2021.1252
Abstrakt:	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. Competing Interests: Conflicts of interest: All authors – none to declare. (GERMS.)
Databáze:	MEDLINE
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