Factors associated with unsuccessful treatment outcome for tuberculosis in previously treated patients in Cali, Colombia, during the period 2015-2019

• Published in: Biomedica : revista del Instituto Nacional de Salud Vol. 43; no. 3; p. 360
• Main Authors: Varela, Liddy, Ortiz, Jimena, García, Pamela K, Luna, Lucy, Fuertes-Bucheli, José F, Pacheco, Robinson
• Format: Journal Article
• Language: English; Spanish
• Published: Colombia 30-09-2023
• Subjects: Adolescent; Adult; Cohort Studies; Colombia - epidemiology; Diabetes Mellitus; HIV Infections; Humans; Recurrence; Retrospective Studies; Substance-Related Disorders; Treatment Outcome; Tuberculosis; Colombia; pulmonary; health services accessibility; Tuberculosis; treatment adherence and compliance; epidemiological factors; communicable disease control
• ISSN: 2590-7379
• DOI: 10.7705/biomedica.6961

Introduction. The success rates in the treatment of tuberculosis are suboptimal.
Objective. To identify associated factors with the lack of success of antituberculosis treatment in patients with a tuberculosis treatment history.
Materials and methods. We performed a retrospective, analytical, observational, and cohort study of patients reentering the Mycobacterium program in Cali, Colombia. We included patients over 15 years old with pulmonary tuberculosis between 2015 and 2019 and a history of tuberculosis treatment. Patients with drug-resistant tuberculosis were excluded.
Results. A total of 605 patients with a treatment history were included, 60% due to unfinished treatment and 40% due to relapse. Compared to patients reentering due to relapse (ORa=2.34, CI=1.62-3.38), the independent variables associated with treatment failure at discharge were homelessness (ORa=2.45, CI=1.54-3.89), substance dependence (ORa=1.95, CI=1.24-3.05), tuberculosis/HIV coinfection (ORa=1.69, CI=1.00-2.86), diabetes (ORa=1.89, CI=1.29-2.77), and unfinished previous tuberculosis treatment due to follow-up loss, abandonment, or other causes. Programmatic variables favoring treatment success were voluntary HIV testing counseling (p<0.001) and HIV testing (p<0.001).
Conclusion. Homelessness, substance dependence, tuberculosis/HIV coinfection, diabetes, and incomplete previous treatment due to loss to follow-up, abandonment, or treatment failure hindered the success of antituberculosis. These characteristics should be identified and addressed during the initial care of patients reentering treatment for tuberculosis.