Patient predictors of poor drug sensitive tuberculosis treatment outcomes in Kyiv Oblast, Ukraine [version 2; peer review: 2 approved, 1 approved with reservations]

F1000Research

Mariya Bachmaha¹  Megan B. Murray²  Vasyl Petrenko³  Viatcheslav Krasiuk³  Omowunmi Aibana⁴  Timothy P. Flanigan⁵  Natasha Rybak⁵  Andrej Slavuckij⁶ 

[1] Brown University School of Public Health, Providence, RI, USA;Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA;Department of Pulmonology, Bogomolets National Medical University, Kyiv, Ukraine;Division of General Internal Medicine, The University of Texas Health Science Center at Houston - McGovern Medical School, Houston, TX, USA;Division of Infectious Diseases, The Miriam Hospital, Warren Alpert Medical School at Brown University, Providence, RI, USA;World Health Organization, Illiyinskaya Street, Kyiv, Ukraine;

关键词: health systems & services research;   

DOI  :  10.12688/f1000research.12687.2

来源: DOAJ

【 摘 要 】

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. Frequent alcohol use (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.

【 授权许可】

Unknown