Evaluating Tuberculosis Treatment Outcomes in Haiti from 2018 to 2019: A Competing Risk Analysis

Overview

Journal IJID Reg

Specialty Infectious Diseases

Date 2024 Apr 5

PMID 38577553

Authors

Nernst-Atwood Raphael

Pierre Anthony Garraud

Maroussia Roelens

Jean Patrick Alfred

Milo Richard

Janne Estill

Olivia Keiser

Aziza Merzouki

Affiliations

Soon will be listed here.

Abstract

Objectives: This study assesses tuberculosis (TB) treatment outcomes in Haiti.

Methods: Data from drug-susceptible patients with TB (2018-2019) were analyzed using the Fine & Gray model with multiple imputation.

Results: Of the 16,545 patients, 14.7% had concurrent HIV coinfection, with a 66.2% success rate. The median treatment duration was 5 months, with patients averaging 30 years (with an interquartile range of 22-42 years). The estimated hazard of achieving a successful treatment outcome decreased by 2.5% and 8.1% for patients aged 45 and 60 years, respectively, compared with patients aged 30 years. Male patients had a 6.5% lower estimated hazard of success than their female counterparts. In addition, patients coinfected with HIV experienced a 35.3% reduction in the estimated hazard of achieving a successful treatment outcome compared with those with a negative HIV serologic status.

Conclusions: Integrated health care approaches should be implemented, incorporating innovative solutions, such as machine learning algorithms combined with geographic information systems and non-conventional data sources (including social media), to identify TB hotspots and high-burden households.

References

Manyazewal T, Woldeamanuel Y, Fekadu A, Holland D, Marconi V . Effect of Digital Medication Event Reminder and Monitor-Observed Therapy vs Standard Directly Observed Therapy on Health-Related Quality of Life and Catastrophic Costs in Patients With Tuberculosis: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2022; 5(9):e2230509. PMC: 9478770. DOI: 10.1001/jamanetworkopen.2022.30509. View

Schoni-Affolter F, Keiser O, Mwango A, Stringer J, Ledergerber B, Mulenga L . Estimating loss to follow-up in HIV-infected patients on antiretroviral therapy: the effect of the competing risk of death in Zambia and Switzerland. PLoS One. 2011; 6(12):e27919. PMC: 3242760. DOI: 10.1371/journal.pone.0027919. View

Maciel E, Amancio J, de Castro D, Braga J . Social determinants of pulmonary tuberculosis treatment non-adherence in Rio de Janeiro, Brazil. PLoS One. 2018; 13(1):e0190578. PMC: 5755789. DOI: 10.1371/journal.pone.0190578. View

Chenciner L, Annerstedt K, Pescarini J, Wingfield T . Social and health factors associated with unfavourable treatment outcome in adolescents and young adults with tuberculosis in Brazil: a national retrospective cohort study. Lancet Glob Health. 2021; 9(10):e1380-e1390. DOI: 10.1016/S2214-109X(21)00300-4. View

Gebreweld F, Kifle M, Gebremicheal F, Simel L, Gezae M, Ghebreyesus S . Factors influencing adherence to tuberculosis treatment in Asmara, Eritrea: a qualitative study. J Health Popul Nutr. 2018; 37(1):1. PMC: 5756387. DOI: 10.1186/s41043-017-0132-y. View

Hernandez D, Muriel A, Castro de la Nuez P, Alonso-Titos J, Ruiz-Esteban P, Duarte A . Survival in Southern European patients waitlisted for kidney transplant after graft failure: A competing risk analysis. PLoS One. 2018; 13(3):e0193091. PMC: 5841738. DOI: 10.1371/journal.pone.0193091. View

Oliosi J, Reis-Santos B, Locatelli R, Sales C, Filho W, da Silva K . Effect of the Bolsa Familia Programme on the outcome of tuberculosis treatment: a prospective cohort study. Lancet Glob Health. 2018; 7(2):e219-e226. DOI: 10.1016/S2214-109X(18)30478-9. View

Kim J, Kim J, Kim S . Additive-multiplicative hazards regression models for interval-censored semi-competing risks data with missing intermediate events. BMC Med Res Methodol. 2019; 19(1):49. PMC: 6404346. DOI: 10.1186/s12874-019-0678-z. View

Churchyard G . A stratified approach to tuberculosis treatment. Nat Med. 2018; 24(11):1639-1641. DOI: 10.1038/s41591-018-0244-y. View

10.

Sahile Z, Yared A, Kaba M . Patients' experiences and perceptions on associates of TB treatment adherence: a qualitative study on DOTS service in public health centers in Addis Ababa, Ethiopia. BMC Public Health. 2018; 18(1):462. PMC: 5891937. DOI: 10.1186/s12889-018-5404-y. View

11.

Tola A, Mishore K, Ayele Y, Mekuria A, Legese N . Treatment Outcome of Tuberculosis and Associated Factors among TB-HIV Co-Infected Patients at Public Hospitals of Harar Town, Eastern Ethiopia. A five-year retrospective study. BMC Public Health. 2019; 19(1):1658. PMC: 6902430. DOI: 10.1186/s12889-019-7980-x. View

12.

Dorman S, Nahid P, Kurbatova E, Phillips P, Bryant K, Dooley K . Four-Month Rifapentine Regimens with or without Moxifloxacin for Tuberculosis. N Engl J Med. 2021; 384(18):1705-1718. PMC: 8282329. DOI: 10.1056/NEJMoa2033400. View

13.

Hatwiinda S, Topp S, Siyambango M, Harris J, Maggard K, Chileshe C . Poor continuity of care for TB diagnosis and treatment in Zambian Prisons: a situation analysis. Trop Med Int Health. 2017; 23(2):243-250. DOI: 10.1111/tmi.13024. View

14.

Burke R, Nliwasa M, Feasey H, Chaisson L, Golub J, Naufal F . Community-based active case-finding interventions for tuberculosis: a systematic review. Lancet Public Health. 2021; 6(5):e283-e299. PMC: 8082281. DOI: 10.1016/S2468-2667(21)00033-5. View

15.

Abdu M, Ali Y, Anteneh S, Yesuf M, Birhanu A, Mohamed S . Determinant factors for the occurrence of tuberculosis after initiation of antiretroviral treatment among adult patients living with HIV at Dessie Referral Hospital, South Wollo, Northeast Ethiopia, 2020. A case-control study. PLoS One. 2021; 16(3):e0248490. PMC: 7963039. DOI: 10.1371/journal.pone.0248490. View

16.

Gadoev J, Asadov D, Tillashaykhov M, Tayler-Smith K, Isaakidis P, Dadu A . Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study. PLoS One. 2015; 10(6):e0128907. PMC: 4467982. DOI: 10.1371/journal.pone.0128907. View

17.

Austin P, Fine J . Practical recommendations for reporting Fine-Gray model analyses for competing risk data. Stat Med. 2017; 36(27):4391-4400. PMC: 5698744. DOI: 10.1002/sim.7501. View

18.

Araia Z, Kibreab F, Kibrom A, Mebrahtu A, Girmatsion M, Teklehiwet Y . Determinants of unsuccessful tuberculosis treatment outcome in Northern Red Sea region, Eritrea. PLoS One. 2022; 17(8):e0273069. PMC: 9377576. DOI: 10.1371/journal.pone.0273069. View

19.

Graham S, Raboud J, McClelland R, Jaoko W, Ndinya-Achola J, Mandaliya K . Loss to follow-up as a competing risk in an observational study of HIV-1 incidence. PLoS One. 2013; 8(3):e59480. PMC: 3595247. DOI: 10.1371/journal.pone.0059480. View

20.

Mao L, Lin D, Zeng D . Semiparametric regression analysis of interval-censored competing risks data. Biometrics. 2017; 73(3):857-865. PMC: 5561531. DOI: 10.1111/biom.12664. View