Outcome and determinants of Directly Observed Short-course treatment for tuberculosis patients

Alaa Hussein Khudhair  Al-Janabi

doi:10.48165/sajssh.2023.4604

Authors

Alaa Hussein Khudhair Al-Janabi Department of epidemiology, Directorate of Health, Ministry of Health, Babylon, Iraq.

DOI:

https://doi.org/10.48165/sajssh.2023.4604

Keywords:

DOTS, TB, treatment, outcome, Babylon

Abstract

Background: The Directly Observed Treatment Short Course (DOTS) is a well-established and cost-effective strategy for treating Tuberculosis. It efficiently transforms infectious cases into non infectious ones, effectively interrupting the transmission cycle of the disease. Objectives: Measure the treatment outcomes in TB patients during 2016-2020, describe the socio-demographic and clinical profile of TB patients and evaluate the performance of the National TB program in Babil governorate based on WHO indicators. Methods: A descriptive cross-sectional study was done. All TB patients in the NTP Center of Babil governorate under the DOTS program from 2016 to 2020 were included. A form was developed to compile socio-demographic data, clinical presentation, and treatment outcomes. Results: A total number of cases was 1723. The mean age was 40.0 (± 21.0) years. The female constituted 53.8% of cases. The patients aged ≥ 65 years had the highest percentage of total cases 279 (16.2%). Pulmonary tuberculosis (PTB) constituted 56.1% of the cases 50.5% of them had smear-positive. The most common site for extrapulmonary tuberculosis (EPTB) was lymph nodes 41.1%. Treatment success was attained in 93.7%, while 3.3% of patients dead. The patients aged ≥ 65 years have the lowest success rate and highest treatment unsuccess rate opposite to young age groups (p 0.002). Conclusion: The treatment outcome target planned by WHO was achieved. The case detection rate of all form was low. The age and the site of TB significantly affected the outcome of treatment.

References

Muhsen, F. A. R., Mohamed, K. G., & Alhatami, A. O. (2015). Assessment Treatment Outcomes of Directly Observed Treatment Short Course Programme among Tuberculosis Patients in Al-Najaf Governorate, Iraq. Journal of US-China Medical Science, 12, 120-126.

Abebe, G., Bonsa, Z., & Kebede, W. (2019). Treatment outcomes and associated factors in tuberculosis patients at Jimma University Medical Center: A 5-year retrospective study. International journal of mycobacteriology, 8(1), 35-41.

Chakaya, J., Khan, M., Ntoumi, F., Aklillu, E., Fatima, R., Mwaba, P., ... & Zumla, A. (2021). Global Tuberculosis Report 2020–Reflections on the Global TB burden, treatment and prevention efforts. International journal of infectious diseases, 113, S7-S12.

Obaid, A. F., Abdulrasol, Z. A., Jasim Shlash, A. M., Tuman, M. R., & Hussain, M. D. (2023). Assessment of Missing Opportunity of Vaccination at Primary Health Care Center: A Retrospective Study. Journal of Contemporary Medical Sciences, 9(1), 77-81.

Feng, J. Y., Huang, S. F., Ting, W. Y., Chen, Y. C., Lin, Y. Y., Huang, R. M., ... & Su, W. J. (2012). Gender differences in treatment outcomes of tuberculosis patients in Taiwan: a prospective observational study. Clinical Microbiology and Infection, 18(9), E331-E337.

Fukunaga, R., Glaziou, P., Harris, J. B., Date, A., Floyd, K., & Kasaeva, T. (2021). Epidemiology of tuberculosis and progress toward meeting global targets—worldwide, 2019. Morbidity and Mortality Weekly Report, 70(12), 427.

Gebrezgabiher, G., Romha, G., Ejeta, E., Asebe, G., Zemene, E., & Ameni, G. (2016). Treatment outcome of tuberculosis patients under directly observed treatment short course and factors affecting outcome in southern Ethiopia: a five-year retrospective study. PloS one, 11(2), e0150560.

Getahun, B., Ameni, G., Biadgilign, S., & Medhin, G. (2011). Mortality and associated risk factors in a cohort of tuberculosis patients treated under DOTS programme in Addis Ababa, Ethiopia. BMC infectious diseases, 11, 1-8.

Guha, U., & Kumari, K. (2023). A Study on Convergent Action at the Grassroots during COVID 19 Pandemic. South Asian Journal of Social Sciences and Humanities, 4(5), 112-123.

Iraq Ministry of Health. National Specialized center for Chest and Respiratory diseases. Epidemiology of Tuberculosis in Iraq 2015, National Tuberculosis Control Program. Elevennth Edition

Jappar, S. B., & Low, S. Y. (2015). Tuberculosis trends over a five-year period at a tertiary care university-affiliated hospital in Singapore. Singapore medical journal, 56(9), 502.

Kadim, J. R., Sabti, Y. M., Ali, G., & Abbas, Y. A. (2021). The effect of applying organizational justice on job burnout (an applied study in the municipality of Samawah). South Asian Journal of Social Sciences and Humanities, 2(2), 135-155.

Lange, C., Chesov, D., Heyckendorf, J., Leung, C. C., Udwadia, Z., & Dheda, K. (2018). Drug‐ resistant tuberculosis: an update on disease burden, diagnosis and treatment. Respirology, 23(7), 656-673.

Lee, J. Y. (2015). Diagnosis and treatment of extrapulmonary tuberculosis. Tuberculosis and respiratory diseases, 78(2), 47-55.

Lin, C. Y., Chen, T. C., Lu, P. L., Lai, C. C., Yang, Y. H., Lin, W. R., ... & Chen, Y. H. (2013). Effects of gender and age on development of concurrent extrapulmonary tuberculosis in patients with pulmonary tuberculosis: a population based study. PLoS One, 8(5), e63936.

Merza, M. A. (2020). A 5-year experience characterizing the demographic and clinical profile and directly observed treatment short-course treatment outcome in National Tuberculosis Center of Duhok province, Iraqi Kurdistan. SAGE Open Medicine, 8, 2050312120921055.

Ncube, R. T., Takarinda, K. C., Zishiri, C., Van den Boogaard, W., Mlilo, N., Chiteve, C., ... & Sandy, C. (2017). Age-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable?. Public health action, 7(3), 212-217.

Pang, Y., An, J., Shu, W., Huo, F., Chu, N., Gao, M., ... & Xu, S. (2019). Epidemiology of extrapulmonary tuberculosis among inpatients, China, 2008–2017. Emerging infectious diseases, 25(3), 457.

Qian, X., Nguyen, D. T., Lyu, J., Albers, A. E., Bi, X., & Graviss, E. A. (2018). Risk factors for extrapulmonary dissemination of tuberculosis and associated mortality during treatment for extrapulmonary tuberculosis. Emerging microbes & infections, 7(1), 1-14.

Roy, R., & Jose, A. (2023). Gender–Caste Hegemony and Victimhood: A Study on Untouchable and The God of Small Things. South Asian Journal of Social Sciences and Humanities, 4(5), 186-197.

Sotgiu, G., Sulis, G. and Matteelli, A. (2017). Tuberculosis—a World Health Organization Perspective. In Tuberculosis and Nontuberculous Mycobacterial Infections, D. Schlossberg (Ed.). https://doi.org/10.1128/9781555819866.ch12

Suleman, D., & binti Ab Rehman, F. (2020). Transgender Issues in Indian Society from the Viewpoint of Arundhati Roy’s Novel, The Ministry of Utmost Happiness. South Asian Journal of Social Sciences and Humanities, 1(3), 159-172.

Suleman, D., & Mohamed, A. H. (2019). Examining the Women Issues and Child Abuse as Mirrored by Arundhati Roy’s The God of Small Things. Indonesian Journal of Cultural and Community Development, 3, 10-21070.

Suleman, D., Kashif, A., Tilwani, S. A., & Rabeea, L. K. (2023). Impacts of Unjust Traditional Practices on Unhappy Marriage Life: An Empirical Assessment of the Social Context in the Kurdish Region. Kurdish Studies, 11(1), 145-160.

Suleman, D., Mehmood, W., Iqbal, F., & Ashraf, M. U. (2021). Covid-19 Suicidal Cases in India in the Light of Poverty: Upcoming Challenges for India in Terms of Economy. Review of International Geographical Education Online, 11(10), 2108-2118.

Suleman, D., Mohamed, A. H., & Ahmmed, M. F. (2020). Political and Gender issues in Arundhati Roy’s" The Ministry of Utmost Happiness". Indonesian Journal of Cultural and Community Development, 5, 10-21070.

Sunnetcioglu, A., Sunnetcioglu, M., Binici, I., Baran, A. I., Karahocagil, M. K., & Saydan, M. R. (2015). Comparative analysis of pulmonary and extrapulmonary tuberculosis of 411 cases. Annals of clinical microbiology and antimicrobials, 14(1), 1-5.

Talib Al Sa'ady, A., Abdulameer Abdulrasol, Z., Fadhil Obaid, A., Abdul-Amir Makki Alhindy, H., & S. Al-Mumin, A. (2022). Prevalence of adverse effects from COVID-19 vaccine among Iraqi adults: A retrospective cross-sectional study. Journal of Emergency Medicine, Trauma & Acute Care, 2022(3), 6.

Tesema, T., Seyoum, D., Ejeta, E., & Tsegaye, R. (2020). Determinants of tuberculosis treatment outcome under directly observed treatment short courses in Adama City, Ethiopia. Plos one, 15(4), e0232468.