Comparison of first-line tuberculosis treatment outcomes between previously treated and new patients: a retrospective study in Machakos subcounty Kenya
Introduction:
Since 2016 patients with rifampicin-susceptible tuberculosis TB have been treated with thern6-month first-line regimen regardless of treatment history. We assessed treatment outcomes of previouslyrntreated and new patients in Machakos subcounty Kenya
Objectives:
We therefore assessed the outcomes of previouslyrntreated and new patients enrolled on the standard 6-monthrnrifampicin regimen between 2016 and 2017 in Machakos subcounty Kenya and in patients with rifampicin-susceptible TBrnusing the Xpert Mycobacterium tuberculosis MTB/resistance torifampicin RIF test.
Methodology:
We performed a retrospective cohort study in patients started on first-line treatment between 2016rnand 2017. Firths logistic regression was used to estimate the effect of previous treatment on having a programmatic adverse outcome either lost to follow-up death failure and treatment failure vs treatment successrneither cure or completion.
Findings:
Of 1024 new and 79 previously treated patients 88.1 and 74.7 were treated successfully 6.5rnand 7.6 died 4.2 and 10.1 were lost to follow-up and 1.2 and 7.6 had treatment failure respectively.rnPrevious treatment predicted having a programmatic adverse outcome adjusted odds ratio aOR 2.4 95 confidence interval CI 1.4 to 4.2 and treatment failure aOR 7.3 95 CI 2.6 to 20.4 but not mortality. Similarrncorrelations were found in 334 new and previously treated patients with confirmed baseline rifampicin suscep
Results:
Conclusion:
Previously treated patients were more at risk of experiencing a poor treatment outcome mainlyrnlost to follow-up and treatment failure. Adherence support may reduce lost to follow-up. Rifampicin drug susceptibility testing coverage should increase. More robust retreatment regimens may reduce treatment fai
Publication Information
Author(s):
Focus County(s):
Machakos County
Programme Area(s):
Infectious and Parasitic Diseases
Research Priority Area(s):
Disease Domain(s):
TB
Document History:
Publication Date: 28.Aug.2020
Conference Title:
Venue: