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Background: Retreatment tuberculosis poses a significant threat including drug resistance to tuberculosis control program. However, recurrence and its cause in the era of Human Immuno Deficiency Virus (HIV) have not been well described. Thus, this study was conducted in Addis Ababa to determine recurrent TB treatment outcomes by type of recurrence and HIV status.
Objective: The aim of the study was to assess treatment outcome of retreatment tuberculosis in relation to retreatment TB category and HIV status and investigate factors associated with successful treatment outcome.
Method: A retrospective registered based cohort study design was used to assess the outcome of retreatment tuberculosis category patients above the age of 15 years covering from July 2009 to July 2012 was conducted to determine the treatment outcome of retreatment tuberculosis category in nine health centers in Addis Ababa. Sex, age of TB patients, TB categories, weights, residence categories of treatment regimen, HIV status, ART status, sputum testing and results and documented treatment outcome were extracted from purposively selected three sub-cities that have optimal case in Addis Ababa, Ethiopia.
Results: Five hundred sixty-five retreatment pulmonary TB patients were included in this study. 525 (92.9%) were HIV tested, 192 (36.6%) were HIV positive 105(54.6%) were in antiretroviral treatment, more females were HIV positive 95 (43.4%) compared with male 97 (32.4%), there were 485 (85.5%) with relapse TB, 42 (7.4%) with treatment after default and 40 (7.1%) with failure after treatment TB. The overall treatment success was 65.6%with 11.4% defaulted being the most unsuccessful treatment outcome. Patients who converted sputum at intensive phase had higher treatment success. (Adjusted OR=6.53, 95% CI: 3.059-13.97) and among retreatment TB categories relapse cases had successful treatment outcome (Adjusted. OR= 2.4, 95% CL: 1.017-10.09).
Conclusions: Types of TB and sputum test at intensive phase were significantly associated with treatment success. The treatment success obtained in this study was lower than the global success in 2011 and the small number of drug sensitivity test may hinder the actual number of MDR cases in retreatment tuberculosis. To improve treatment outcome continuous monitoring and follow-up during the course of treatment and further investigation on the cause of the observed finding in lower treatment success will be recommended. |
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