Predictors of tuberculosis treatment success under the DOTS program in Namibia

Kibuule, Dan, Verbeeck, Roger K, Nunurai, Ruswa, Mavhunga, Farai, Ene, Ette, Godman, Brian ORCID: 0000-0001-6539-6972 and Rennie, Timothy W (2018) Predictors of tuberculosis treatment success under the DOTS program in Namibia. EXPERT REVIEW OF RESPIRATORY MEDICINE, 12 (11). pp. 979-987.

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Abstract

<h4>Objectives</h4>Optimal treatment success rates are critical to end tuberculosis in Namibia. Despite the scale-up of high quality directly observed therapy short-course strategy (DOTS) in Namibia, treatment success falls short of the global target of 90%. The objective of this study was to ascertain the predictors of treatment success rates under DOTS in Namibia to provide future direction.<h4>Methods</h4>A nation-wide comparative analysis of predictors of treatment success was undertaken. Tuberculosis cases in the electronic tuberculosis register were retrospectively reviewed over a 10-year period, 2004-2016. The patient, programmatic, clinical, and treatment predictors of treatment success were determined by multivariate logistic regression modeling using R software.<h4>Results</h4>104,603 TB cases were registered at 300 DOTS sites in 37 districts. The 10-year period treatment success rate was 80%, and varied by region (77.2%-89.2%). The patient's sex and age were not significant predictors. The independent predictors for treatment success as were: Region of DOTS implementation (p=0.001), type of directly observed treatment (DOT) supporter (p<0.001), sputum conversion at 2 months (p=0.013), DOT regimen (p<0.001), cotrimoxazole prophylaxis (p=0.002), and HIV co-infection (p=0.001).<h4>Conclusion</h4>Targeted programmatic, clinical and treatment interventions are required to enhance DOTS treatment success in Namibia. These are now ongoing.

Item Type:	Article
Uncontrolled Keywords:	DOTS program, TB, predictors, effectiveness, outcomes
Depositing User:	Symplectic Admin
Date Deposited:	25 Sep 2018 07:24
Last Modified:	19 Jan 2023 01:16
DOI:	10.1080/17476348.2018.1520637
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3026705