Tuberculosis treatment outcomes of six and eight month treatment regimens in districts of Southwestern Ethiopia: a comparative cross-sectional study
Abstract Background A switch of continuation phase tuberculosis (TB) treatment regimen from Ethambutol (E) and Isoniazid (H) combination for 6 months (6EH) to Rifampicin (R) and Isoniazid (H) combination for 4 months (4RH) was recommended. However, the effect of the regimen switch in Ethiopian setti...
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| Format: | Article |
| Language: | English |
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BMC
2016-11-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-016-1917-0 |
| _version_ | 1818458053146574848 |
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| author | Abyot Asres Degu Jerene Wakgari Deressa |
| author_facet | Abyot Asres Degu Jerene Wakgari Deressa |
| author_sort | Abyot Asres |
| collection | DOAJ |
| description | Abstract Background A switch of continuation phase tuberculosis (TB) treatment regimen from Ethambutol (E) and Isoniazid (H) combination for 6 months (6EH) to Rifampicin (R) and Isoniazid (H) combination for 4 months (4RH) was recommended. However, the effect of the regimen switch in Ethiopian setting is not known. Methods A comparative cross-sectional study among 790 randomly selected new cases of TB (395 each treated with 4RH and 6EH during the continuation phase) was conducted in nine health centers and one hospital in three zones in southwestern Ethiopia. Data were abstracted from the standard unit TB register composed of standard case and treatment outcome definitions. Data were analyzed using STATA version 13 where binary logistic regression was fitted to identify independent predictors of unsuccessful treatment outcomes at 5 % significance level. Results Over all, 695 (88 %) of the patients had a successful treatment outcome with statistically significant difference (85.3 % vs 90.6 %, p = 0.02) among the 6HE and 4RH regimens, respectively. After adjusting for confounders, 4RH continuation phase treatment regimen adjusted odds ratio (AOR) [(95 % confidence interval (CI)) 0.55 (0.34,0.89)], age [AOR (95 % CI 1.02 (1.001,1.022)], rural residence [AOR (95 % CI) 2.1 (1.18,3.75)] Human Immunodeficiency virus (HIV) positives [AOR (95 % CI) 2.39 (1.12,5.07)] and increased weight at the end of the second month [AOR (95 % CI 0.28 (0.11,0.72)] independently predicted treatment outcome. Conclusion The switch of continuation phase TB treatment regimen from 6EH to 4RH has brought better treatment outcomes which imply applicability of the recommendation in high prevalent and resource constrained settings. Therefore, it should be maintained and augmented through further studies on its impact among the older, rural residents and HIV positives. |
| first_indexed | 2024-12-14T22:52:20Z |
| format | Article |
| id | doaj.art-e91ae471feb14950bce70cdf4382d626 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-14T22:52:20Z |
| publishDate | 2016-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-e91ae471feb14950bce70cdf4382d6262022-12-21T22:44:41ZengBMCBMC Infectious Diseases1471-23342016-11-011611810.1186/s12879-016-1917-0Tuberculosis treatment outcomes of six and eight month treatment regimens in districts of Southwestern Ethiopia: a comparative cross-sectional studyAbyot Asres0Degu Jerene1Wakgari Deressa2Department of Public Health, College of Health Sciences, MizanTepi UniversityManagement Science for Health, HEAL TB projectDepartment of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa UniversityAbstract Background A switch of continuation phase tuberculosis (TB) treatment regimen from Ethambutol (E) and Isoniazid (H) combination for 6 months (6EH) to Rifampicin (R) and Isoniazid (H) combination for 4 months (4RH) was recommended. However, the effect of the regimen switch in Ethiopian setting is not known. Methods A comparative cross-sectional study among 790 randomly selected new cases of TB (395 each treated with 4RH and 6EH during the continuation phase) was conducted in nine health centers and one hospital in three zones in southwestern Ethiopia. Data were abstracted from the standard unit TB register composed of standard case and treatment outcome definitions. Data were analyzed using STATA version 13 where binary logistic regression was fitted to identify independent predictors of unsuccessful treatment outcomes at 5 % significance level. Results Over all, 695 (88 %) of the patients had a successful treatment outcome with statistically significant difference (85.3 % vs 90.6 %, p = 0.02) among the 6HE and 4RH regimens, respectively. After adjusting for confounders, 4RH continuation phase treatment regimen adjusted odds ratio (AOR) [(95 % confidence interval (CI)) 0.55 (0.34,0.89)], age [AOR (95 % CI 1.02 (1.001,1.022)], rural residence [AOR (95 % CI) 2.1 (1.18,3.75)] Human Immunodeficiency virus (HIV) positives [AOR (95 % CI) 2.39 (1.12,5.07)] and increased weight at the end of the second month [AOR (95 % CI 0.28 (0.11,0.72)] independently predicted treatment outcome. Conclusion The switch of continuation phase TB treatment regimen from 6EH to 4RH has brought better treatment outcomes which imply applicability of the recommendation in high prevalent and resource constrained settings. Therefore, it should be maintained and augmented through further studies on its impact among the older, rural residents and HIV positives.http://link.springer.com/article/10.1186/s12879-016-1917-0TuberculosisContinuation phasetreatment regimenTreatment outcomeEthiopia |
| spellingShingle | Abyot Asres Degu Jerene Wakgari Deressa Tuberculosis treatment outcomes of six and eight month treatment regimens in districts of Southwestern Ethiopia: a comparative cross-sectional study BMC Infectious Diseases Tuberculosis Continuation phase treatment regimen Treatment outcome Ethiopia |
| title | Tuberculosis treatment outcomes of six and eight month treatment regimens in districts of Southwestern Ethiopia: a comparative cross-sectional study |
| title_full | Tuberculosis treatment outcomes of six and eight month treatment regimens in districts of Southwestern Ethiopia: a comparative cross-sectional study |
| title_fullStr | Tuberculosis treatment outcomes of six and eight month treatment regimens in districts of Southwestern Ethiopia: a comparative cross-sectional study |
| title_full_unstemmed | Tuberculosis treatment outcomes of six and eight month treatment regimens in districts of Southwestern Ethiopia: a comparative cross-sectional study |
| title_short | Tuberculosis treatment outcomes of six and eight month treatment regimens in districts of Southwestern Ethiopia: a comparative cross-sectional study |
| title_sort | tuberculosis treatment outcomes of six and eight month treatment regimens in districts of southwestern ethiopia a comparative cross sectional study |
| topic | Tuberculosis Continuation phase treatment regimen Treatment outcome Ethiopia |
| url | http://link.springer.com/article/10.1186/s12879-016-1917-0 |
| work_keys_str_mv | AT abyotasres tuberculosistreatmentoutcomesofsixandeightmonthtreatmentregimensindistrictsofsouthwesternethiopiaacomparativecrosssectionalstudy AT degujerene tuberculosistreatmentoutcomesofsixandeightmonthtreatmentregimensindistrictsofsouthwesternethiopiaacomparativecrosssectionalstudy AT wakgarideressa tuberculosistreatmentoutcomesofsixandeightmonthtreatmentregimensindistrictsofsouthwesternethiopiaacomparativecrosssectionalstudy |