Treatment Outcomes among Drug Sensitive Tuberculosis Patients in Tana River County - Kenya, 2014–2017

  • Public health surveillance
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Background:
Kenya is among 22 high burden countries that together account for 80% of TB cases globally. In 2017, Kenya achieved a treatment success rate (TSR) of 83.2% and cure rate (CR) of 65%. Tana River County had TSR of 85%, CR of 72.5% for 2017 and has not met set targets of 90% TSR and 85% CR over the years. We described treatment outcomes among drug sensitive TB patients.
Methods:
We reviewed both private and public facility records for Tana River County from the national Electronic TB Patient Management System from 2014–2017. A case was a record of TB confirmed by sputum microscopy, Gene Xpert or culture, or diagnosed clinically. We excluded records of patients with drug resistant TB. We collected socio- demographic and clinical information. Treatment outcomes were classified as complete, cured, died, failed, lost-to- follow-up and not evaluated. We calculated descriptive statistics.
Results:
A total of 1,678 records were reviewed; males were 58.6% (983/1,678), median age of patients on treatment was 30.1 years (Range 6 weeks – 99 years), 10.4% (174/1,678) were HIV positive, 86.6% (1453/1,678) were treated successfully, 7% (118/1,678) died, 4.1% (69/1,678) lost-to-follow-up and 2% (34/1,678) not evaluated. Among 773 (46%) bacteriolog- ically confirmed cases; 74.3% (574/773) got cured, 14.1% (109/773) completed treatment without follow-up sputum tests, 4.9% (38/773) died and 3.5% (27/773) lost-to-follow-up. All 174 HIV positive patients were on preventive therapy, 94% (164/174) were on Anti-retroviral Therapy (ART), despite this, 19% (33/174) died. Among the 7% (118/1,678) who died, 25.4% (30/118) received nutritional intervention, 80.5% (95/118) had pulmonary TB and among them 59% (56/95) were clinically diagnosed.
Conclusion
Pulmonary TB may have contributed to most of the deaths. A fifth of the HIV positive cases died despite being on ART. We recommend improved integration of TB treatment with nutrition services and comprehensive HIV care.

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