Predictors of therapy failure in newly diagnosed pulmonary tuberculosis cases in Beira, Mozambique

Tuberculosis (TB) remains a major global health issue, ranking in the top ten causes of death worldwide.. Aims of the study were: i) to evaluate the treatment outcome among TB subjects followed in an outpatient setting and ii) to analyze factors associated with treatment failure in newly diagnosed patients with pulmonary TB in Beira, the second largest city of Mozambique.
All cases of pulmonary TB diagnosed between January and August 2016 were recruited in this observational study from three urban outpatient health-care centers of Beira district. Inclusion criteria were to be a subject aged ≥18 years with a confirmed TB diagnosis Treatment outcomes were defined according to WHO criteria. Logistic regression was used to calculate crude and adjusted odds ratios, 95% confidence intervals and P-value
A total of 301 TB adult patients (32.6% females) were enrolled. Among them, 62 (20.6%) experienced a treatment failure over a 6 months follow-up. On multivariate model, being males (O.R.=1.73; 95%CI: 1.28-2.15), absence of education (O.R.=1.85; 95%CI: 1.02-2.95), monthly income under 50 dollars (O.R.=1.74; 95%CI: 1.24-2.21) and being employed (O.R.=1.57; 95%CI: 1.21-1.70), low BMI values (O.R.=1.42; 95%CI: 1.18-1.72) and HIV status (O.R.=1.42; 95%CI: 1.10-1.78) increased the likelihood of therapy failure over 6 months of follow-up.

In this study, patients who needed more medical attention were young males, malnourished, HIV positive, with low income and low educational degree. These subjects were more likely to fail therapy. Only pharmacological approach is no longer sufficient to guarantee a reduction of TB burden.

Francesco Di Gennaro
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