Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study.

<h4>Background</h4>TB is one of the main health priorities in Uzbekistan and relatively high rates of unfavorable treatment outcomes have recently been reported. This requires closer analysis to explain the reasons and recommend interventions to improve the situation. Thus, by using coun...

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Main Authors: Jamshid Gadoev, Damin Asadov, Mirzagolib Tillashaykhov, Katie Tayler-Smith, Petros Isaakidis, Andrei Dadu, Pierpaolo de Colombani, Sven Gudmund Hinderaker, Nargiza Parpieva, Dilrabo Ulmasova, Avazbek Jalolov, Atadjan Hamraev, Engy Ali, Martin van den Boom, Asmus Hammerich, Ogtay Gozalov, Masoud Dara
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0128907&type=printable
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author Jamshid Gadoev
Damin Asadov
Mirzagolib Tillashaykhov
Katie Tayler-Smith
Petros Isaakidis
Andrei Dadu
Pierpaolo de Colombani
Sven Gudmund Hinderaker
Nargiza Parpieva
Dilrabo Ulmasova
Avazbek Jalolov
Atadjan Hamraev
Engy Ali
Martin van den Boom
Asmus Hammerich
Ogtay Gozalov
Masoud Dara
author_facet Jamshid Gadoev
Damin Asadov
Mirzagolib Tillashaykhov
Katie Tayler-Smith
Petros Isaakidis
Andrei Dadu
Pierpaolo de Colombani
Sven Gudmund Hinderaker
Nargiza Parpieva
Dilrabo Ulmasova
Avazbek Jalolov
Atadjan Hamraev
Engy Ali
Martin van den Boom
Asmus Hammerich
Ogtay Gozalov
Masoud Dara
author_sort Jamshid Gadoev
collection DOAJ
description <h4>Background</h4>TB is one of the main health priorities in Uzbekistan and relatively high rates of unfavorable treatment outcomes have recently been reported. This requires closer analysis to explain the reasons and recommend interventions to improve the situation. Thus, by using countrywide data this study sought to determine trends in unfavorable outcomes (lost-to-follow-ups, deaths and treatment failures) and describe their associations with socio-demographic and clinical factors.<h4>Method</h4>A countrywide retrospective cohort study of all new and previously treated TB patients registered in the National Tuberculosis programme between January 2006 and December 2010.<h4>Results</h4>Among 107,380 registered patients, 67% were adults, with smaller proportions of children (10%), adolescents (4%) and elderly patients (19%). Sixty per cent were male, 66% lived in rural areas, 1% were HIV-infected and 1% had a history of imprisonment. Pulmonary TB (PTB) was present in 77%, of which 43% were smear-positive and 53% were smear-negative. Overall, 83% of patients were successfully treated, 6% died, 6% were lost-to-follow-up, 3% failed treatment and 2% transferred out. Factors associated with death included being above 55 years of age, HIV-positive, sputum smear positive, previously treated, jobless and living in certain provinces. Factors associated with lost-to-follow-up were being male, previously treated, jobless, living in an urban area, and living in certain provinces. Having smear-positive PTB, being an adolescent, being urban population, being HIV-negative, previously treated, jobless and residing in particular provinces were associated with treatment failure.<h4>Conclusion</h4>Overall, 83% treatment success rate was achieved. However, our study findings highlight the need to improve TB services for certain vulnerable groups and in specific areas of the country. They also emphasize the need to develop unified monitoring and evaluation tools for drug-susceptible and drug-resistant TB, and call for better TB surveillance and coordination between provinces and neighbouring countries.
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spelling doaj-art-2b2e115ea671485b83c2e2c6a13cb1952025-08-20T02:34:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01106e012890710.1371/journal.pone.0128907Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study.Jamshid GadoevDamin AsadovMirzagolib TillashaykhovKatie Tayler-SmithPetros IsaakidisAndrei DaduPierpaolo de ColombaniSven Gudmund HinderakerNargiza ParpievaDilrabo UlmasovaAvazbek JalolovAtadjan HamraevEngy AliMartin van den BoomAsmus HammerichOgtay GozalovMasoud Dara<h4>Background</h4>TB is one of the main health priorities in Uzbekistan and relatively high rates of unfavorable treatment outcomes have recently been reported. This requires closer analysis to explain the reasons and recommend interventions to improve the situation. Thus, by using countrywide data this study sought to determine trends in unfavorable outcomes (lost-to-follow-ups, deaths and treatment failures) and describe their associations with socio-demographic and clinical factors.<h4>Method</h4>A countrywide retrospective cohort study of all new and previously treated TB patients registered in the National Tuberculosis programme between January 2006 and December 2010.<h4>Results</h4>Among 107,380 registered patients, 67% were adults, with smaller proportions of children (10%), adolescents (4%) and elderly patients (19%). Sixty per cent were male, 66% lived in rural areas, 1% were HIV-infected and 1% had a history of imprisonment. Pulmonary TB (PTB) was present in 77%, of which 43% were smear-positive and 53% were smear-negative. Overall, 83% of patients were successfully treated, 6% died, 6% were lost-to-follow-up, 3% failed treatment and 2% transferred out. Factors associated with death included being above 55 years of age, HIV-positive, sputum smear positive, previously treated, jobless and living in certain provinces. Factors associated with lost-to-follow-up were being male, previously treated, jobless, living in an urban area, and living in certain provinces. Having smear-positive PTB, being an adolescent, being urban population, being HIV-negative, previously treated, jobless and residing in particular provinces were associated with treatment failure.<h4>Conclusion</h4>Overall, 83% treatment success rate was achieved. However, our study findings highlight the need to improve TB services for certain vulnerable groups and in specific areas of the country. They also emphasize the need to develop unified monitoring and evaluation tools for drug-susceptible and drug-resistant TB, and call for better TB surveillance and coordination between provinces and neighbouring countries.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0128907&type=printable
spellingShingle Jamshid Gadoev
Damin Asadov
Mirzagolib Tillashaykhov
Katie Tayler-Smith
Petros Isaakidis
Andrei Dadu
Pierpaolo de Colombani
Sven Gudmund Hinderaker
Nargiza Parpieva
Dilrabo Ulmasova
Avazbek Jalolov
Atadjan Hamraev
Engy Ali
Martin van den Boom
Asmus Hammerich
Ogtay Gozalov
Masoud Dara
Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study.
PLoS ONE
title Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study.
title_full Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study.
title_fullStr Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study.
title_full_unstemmed Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study.
title_short Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study.
title_sort factors associated with unfavorable treatment outcomes in new and previously treated tb patients in uzbekistan a five year countrywide study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0128907&type=printable
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