Factors Associated with Treatment Failure for Microscopy-positive Pulmonary Tuberculosis at the General Reference Hospital of Beni (DR Congo) between 2010 and 2020: Case-control Study
Kambale Musondivwa Baudouin
The Higher Institute of Medical Technical of Butembo, The Democratic Republic of Congo.
Kule Posho Pascal
Higher Institute of Medical Technical of Beni, The Democratic Republic of Congo.
Dimoke Okito Franck
The Higher Institute of Medical Technical of Kisangani, The Democratic Republic of Congo.
Assani Ramazani Raymond *
The Higher Institute of Medical Technical of Kisangani, The Democratic Republic of Congo.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Failure to treat microscopy-positive pulmonary tuberculosis (MPT+) poses a risk to public health through the spread of infection and could be a gateway to anti-tuberculosis drug resistance. The aim of this study was to describe the epidemiological characteristics of PMT+ TB patients with treatment failure, to measure the degree of association between the various factors and TB treatment failure, and to formulate recommendations for improving NTP activities.
Methods: This is a retrospective case-control study conducted from 1 January 2010 to 31 December 2020 at the CDTMR of the General Referral Hospital of Beni. The cases are patients treated for PMT+ and who had a therapeutic failure. Three controls for each case were selected among patients with PMT+ who were declared cured. Data analysis was performed using Epi-Info version 3.5.3 for Windows.
Results: 128 patients were included in the study. 32 patients were treatment failures. The mean age of cases and controls was 42 years (+/- 14), the M/F sex ratio was 31 and 2.4 in cases and controls respectively, urban residents accounted for 90.3% and 83.2% in cases and controls respectively. Bivariate analysis showed a significant association between treatment failure and weight loss at first control (OR=1.55), non-decrease in bacillary density at first control (OR=25.5) and treatment discontinuation (OR=20.5). After adjustment, weight loss of 1 kg (adjusted OR=1.92), no decrease in BAAR density (adjusted OR=8.30) and treatment discontinuation (adjusted OR=12.2) remained significantly associated with treatment failure.
Conclusion: Active surveillance should be instituted in TB patients with PMT+ who present at first check-up with weight loss, non-decrease in bacillary density on direct examination and/or a notion of treatment discontinuation.
Keywords: Associated factors, treatment failure, pulmonary tuberculosis, microscopy positive