Treatment Outcomes and Factors Impacting Unsuccessful Outcome Among Extrapulmonary Tuberculosis Patients | [Archives of Pharmacy Practice • 2025]

Author(s):

1. Saira Hayat: School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Gelugor, Penang, Malaysia

2. Siti Maisharah Sheikh Ghadzi: School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Gelugor, Penang, Malaysia

3. Faridullah Shah: International Medical College, Peshawar, Khyber Pakhtoon Khawa, Pakistan

4. Saifullah Mehsud: Department of Pharmaceutical Sciences, Abbottabad University of Science and Technology, Havelian, Abbottabad, Pakistan.

5. Obaidullah Malik: Drug Regulatory Authority of Pakistan, Islamabad, Pakistan

6. Fazli Maula: Department of Pulmonology, Peshawar medical college Peshawar, Khyber Pakhtoon Khawa, Pakistan

7. Mohammad Israr: District TB Office Bannu, District Bannu, KPK., Pakistan.

8. Amer Hayat Khan: School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Gelugor, Penang, Malaysia

Abstract:

Tuberculosis remains a significant public health challenge. The study aimed to identify factors influencing treatment outcomes for extrapulmonary tuberculosis (EPTB). From January 1, 2014, to December 31, 2018, a retrospective study was carried out at the District Headquarter (DHQ) Hospital Bannu in Khyber Pakhtunkhwa (KPK), Pakistan. There were 107 EPTB patients in all, aged 12-90 years, with 39.3% of them being female and 60.7% of them being male. With the assent of the patient, demographic information, smoking habits, and co-morbidities were noted. Logistic regression was used in SPSS 23.0 to analyse the data. The treatment success rate was 58.9% among new and relapsed EPTB patients and 24.3% among new smear-positive pulmonary tuberculosis (PTB) patients, with an overall success rate of 83.2%. The likelihood of unsuccessful treatment outcomes was higher among patients aged 36-45 years (AOR = 1.17 95% CL: .416-7.37) and patients with comorbidities (AOR = 2.66; 95% CL: .895-7.94). The patients having symptoms like sweating (AOR = 0.335; 95%CL .130-.863) and cough (AOR = 3.03; 95% CL: 1.35-6.76) were factors associated with the unsuccessful treatment. This study reveals that the ratio of unsuccessful treatment outcomes is still high. Unsuccessful treatment outcomes are due to patient's expiry, defaulter patients, treatment failure, and patient transfer. To reduce treatment interruptions, effective tracing strategies for patients who have been transferred and didn't complete treatment due to being defaulters should be devised and deployed. A follow-up plan should be tailored to each patient.

Page(s): 12-18

DOI: 10.51847/Rd8huM1jXs

Published: Journal: Archives of Pharmacy Practice, Volume: 16, Issue: 1, Year: 2025

Keywords:

Pakistan , extra pulmonary tuberculosis , Successful treatment outcome , Unsuccessful treatment outcome

References:

[1] Organization WH,diagnosis- WH,- WH . .tb-reports/global-tuberculosis-report2023/tb-. World Health Organization global tuberculosis report 2023, : .

[2] Organization WH .2023 .. World Health Organization global tuberculosis report (Pakistan, : .

[3] .2020 .. National TB Control Program of Pakistan (Strategic Plan, 23 : 20-2020.

[4] Organization WH . .20the%20African%20Region_2023%20rep ort. , : .

[5] Jackson C,Stagg H,Doshi A,Pan D,Sinha A,Batra R .2017 .Tuberculosis treatment outcomes among disadvantaged patients in India. Public Health Action, 7(2) : 134-40.

[6] Sariem CN,Odumosu P,Dapar MP,Musa J,Ibrahim L,Aguiyi J,Nigeria J .2020 .Tuberculosis treatment outcomes: a fifteen-year retrospective study in Jos-North and Mangu. BMC Public Health, 10(1) : 1224.

[7] Limenh LW,Kasahun AE,Sendekie AK,Seid AM,Mitku ML,Fenta ET .2024 .Tuberculosis treatment outcomes and associated factors among tuberculosis patients treated at healthcare facilities of Motta Town, Northwest Ethiopia: a five-year retrospective study. Sci Rep, 10(1) : 7695.

[8] Ahmad T,Khan M,Khan MM,Ejeta E,Karami M,Ohia C .2017 .Treatment outcome of tuberculosis patients under directly observed treatment short course and its determinants in Shangla, Khyber-Pakhtunkhwa, Pakistan: a retrospective study. Int J Mycobacteriol, 6(4) : 360.

[9] Tahseen S,Khanzada FM,Baloch AQ,Abbas Q,Bhutto MM,Alizai AW .2020 .Extrapulmonary tuberculosis in Pakistan-A nation-wide multicenter retrospective study. PloS one, 15(4) : e0232134.

[10] Ade S,Affolabi D,Adjobimey M,Ade G,Anagonou S,Kumar AMV .2017 .Operational research within the national tuberculosis control programme in Benin. BMC Res Notes, 10(1) : 651.

[11] Gebrezgabiher G,Romha G,Ejeta E,Asebe G,Zemene E,Ameni G .2016 .Treatment outcome of tuberculosis patients under directly observed treatment short course and factors affecting outcome in southern Ethiopia: a five-year retrospective study. PloS one, 11(2) : e0150560.

[12] Gadoev J,Asadov D,Tillashaykhov M,Tayler-Smith K,Isaakidis P,Dadu A .2015 .Factors associated with unfavorable treatment outcomes in new and previously treated TB patients in Uzbekistan: a five-year countrywide study. PloS one, 10(6) : e0128907.

[13] Puplampu P,Kyeremateng I,Asafu-Adjaye O,Asare AA,Agyabeng K,Sarkodee R .2023 .Evaluation of treatment outcomes among adult patients diagnosed with tuberculosis in Ghana: a 10 year retrospective review. IJID Regions, 11 : 9-14.

[14] Wang X,Cai J,Wang D,Wang Q,Liang H,Ma A .2015 .Registration and management of community patients with tuberculosis in northwest China. Public Health, 129(12) : 1585-90.

[15] Ai X,Men K,Guo L,Zhang T,Zhao Y,Sun X .2010 .Factors associated with low cure rate of tuberculosis in remote poor areas of Shaanxi Province, China: a case control study. BMC Public Health, 10(1) : 1-8.

[16] Atif M,Fatima R,Ahmad N,Babar ZU .2020 .Treatment outcomes of extrapulmonary tuberculosis in Bahawalpur, Pakistan; A record review. J Pharm Policy Pract, 10 : 35.

[17] Chakaya J,Khan M,Ntoumi F,Aklillu E,Fatima R,Mwaba P .2021 .-reflections on the global TB burden, treatment and prevention efforts. Int J Infect Dis, 113 : S7-S12.

[18] Ali MK,Karanja S,Karama M. .2017 .Factors associated with tuberculosis treatment outcomes among tuberculosis patients attending tuberculosis treatment centres in 2016-2017 in Mogadishu, Somalia. Pan Afr Med, 28(1) : 197.

[19] Priedeman Skiles M,Curtis SL,Angeles G,Mullen S,Senik T. Evaluating .2018 .the impact of social support services on tuberculosis treatment default in Ukraine. PLoS One, 13(8) : e0199513.

[20] Stosic M,Vukovic D,Babic D,Antonijevic G,Foley KL,Vujcic I .2018 .Risk factors for multidrug-resistant tuberculosis among tuberculosis patients in Serbia: a case-control study. BMC Public Health, 18(1) : 1-8.

[21] Laghari M,Sulaiman SAS,Khan AH,Memon N. .2018 .6:e5253. PeerJ, 10 : .

[22] Laghari M,Talpur BA,Sulaiman SAS,Khan AH .2020 .Adverse drug reactions of anti tuberculosis treatment among children with tuberculosis. Int J Mycobacteriol, 75(3) : 20-8.

[23] Jaber AAS,Khan AH,Sulaiman SAS .2019 .Evaluating health-related quality of life of lost to follow-up tuberculosis patients in Yemen. Int J Pharmacol Pharm Sci, 13(2) : 83-7.

[24] van Zyl Smit RN,Pai M,Yew WW,Leung C,Zumla A,Bateman E .2010 .Global lung health: the colliding epidemics of tuberculosis, tobacco smoking, HIV and COPD. Eur Respir J, 35(1) : 27-33.

[25] Holden IK,Lillebaek T,Seersholm N,Andersen PH,Wejse C,Johansen IS,Rep Sci .2019 .Predictors for pulmonary tuberculosis treatment outcome in Denmark 2009-2014. , 10(1) : 12995.

[26] Lagharia M,Talpur BA,Sulaimana SAS,Khan AH .2021 .Assessment of adherence to anti-tuberculosis treatment and predictors for non-adherence among the caregivers of children with tuberculosis. Trans R Soc Trop Med Hyg, 10(8) : 904-13.

[27] Kirenga BJ,Levin J,Ayakaka I,Worodria W,Reilly N,Mumbowa F .2014 .Treatment outcomes of new tuberculosis patients hospitalized in Kampala, Uganda: a prospective cohort study. PLoS One, 9(3) : e90614.

[28] Chiang CY,Bai KJ,Lin HH,Chien ST,Lee JJ,Enarson DA .2015 .The influence of diabetes, glycemic control, and diabetes-related comorbidities on pulmonary tuberculosis. PloS one, 10(3) : e0121698.

[29] Alavi-Naini R,Moghtaderi A,Metanat M,Mohammadi M,Zabetian M. .2013 .Factors associated with mortality in tuberculosis patients. J Res Med Sci, 18(1) : 52.

[30] Khan AH,Sulaiman SAS,Hassali MA,Khan KU,Ming LC,Mateen O .2020 .Effect of smoking on treatment outcome among tuberculosis patients in Malaysia; A multicenter study. BMC Public Health, 10 : 854.

[31] Tao NN,Li YF,Song WM,Liu JY,Zhang QY,Xu TT .2021 .Risk factors for drug-resistant tuberculosis, the association between comorbidity status and drug-resistant patterns: a retrospective study of previously treated pulmonary tuberculosis in Shandong, China, during 2004-2019. , 11(6) : e044349.

[32] Khan AH,Sulaiman SAS,Laghari M,Hassali MA,Muttalif AR,Bhatti Z .2019 .Treatment outcomes and risk factors of extrapulmonary tuberculosis in patients with co-morbidities. BMC Infect Dis, 10(1) : 691.

[33] Ridolfi F,Peetluk L,Amorim G,Turner M,Figueiredo M,CordeiroSantos M .2023 .Regional prospective observational research in tuberculosis (RePORT)-Brazil consortium. tuberculosis treatment outcomes in Brazil: different predictors for each type of unsuccessful outcome. Clin Infect Dis, 10(3) : e930-7.

[34] Oshi DC,Oshi SN,Alobu I,Ukwaja KN .2014 .Profile and treatment outcomes of tuberculosis in the elderly in southeastern Nigeria,. , 9(11) : e111910.

[35] Schaaf HS,Collins A,Bekker A,Davies PD .2010 .Tuberculosis at extremes of age. Respirology, 15(5) : 747-63.

[36] Duru CB .2016 .Tuberculosis treatment outcomes and determinants among patients treated in hospitals in Imo state. , 3(06) : 1.

Citations

Downloads

Views