World Health Organization, 2021 Global Tuberculosis Report 2020 [Internet]. Available at: https://www.who.int/publications-detail-redirect/9789240013131.
World Health Organization , 2016. The End TB Strategy [Internet]. Available at: http://www.who.int/tb/strategy/End_TB_Strategy.pdf?ua=1.
Wu Y-C, Lo H-Y, Yang S-L, Chu D-C, Chou P, 2015. Comparing the factors correlated with tuberculosis-specific and non-tuberculosis-specific deaths in different age groups among tuberculosis-related deaths in Taiwan. PloS One 10: e0118929.
Djouma FN, Noubom M, Ngomba AV, Hubert D, Kouomboua PSM, Saah MAF, 2015. Determinants of death among tuberculosis patients in a semi urban diagnostic and treatment centre of Bafoussam, West Cameroon: a retrospective case-control study. Pan Afr Med J 22: 253. Available at: http://www.panafrican-med-journal.com/content/article/22/253/full/.
Lin Y-S, Yen Y-F, 2015. Determinants of mortality before start of and during tuberculosis treatment among elderly patients: a population-based retrospective cohort study. Age Ageing 44: 490–496.
de Faria Gomes NM, da Mota Bastos MC, Marins RM, Barbosa AA, Soares LC, de Oliveira Wilken de Abreu AM, Souto Filho JT, 2015. Differences between risk factors associated with tuberculosis treatment abandonment and mortality. Pulm Med 2015: 546106.
Alavi-Naini R, Moghtaderi A, Metanat M, Mohammadi M, Zabetian M, 2013. Factors associated with mortality in tuberculosis patients. J Res Med Sci 18: 52–55.
Gadoev J et al., 2015. Factors associated with unfavorable treatment outcomes in new and previously treated TB patients in Uzbekistan: a five year countrywide study. PloS One 10: e0128907.
Wu Y-C, Lo H-Y, Yang S-L, Chou P, 2014. Factors correlated with tuberculosis reported after death. Int J Tuberc Lung Dis 18: 1485–1490.
Shuldiner J, Leventhal A, Chemtob D, Mor Z, 2016. Mortality after anti-tuberculosis treatment completion: results of long-term follow-up. Int J Tuberc Lung Dis 20: 43–48.
Lackey B, Seas C, Stuyft PV der, Otero L, 2015. Patient characteristics associated with tuberculosis treatment default: a cohort study in a high-incidence area of Lima, Peru. PloS One 10: e0128541.
Heunis JC, Kigozi NG, Chikobvu P, Botha S, van Rensburg HD, 2017. Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province. BMC Public Health 17: 38. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217308/.
Sawadogo B, Tint KS, Tshimanga M, Kuonza L, Ouedraogo L, 2015. Risk factors for tuberculosis treatment failure among pulmonary tuberculosis patients in four health regions of Burkina Faso, 2009: case control study. Pan Afr Med J 21: 152. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4546781/.
Amante TD, Ahmed TA, 2014. Risk factors for unsuccessful tuberculosis treatment outcome (failure, default and death) in public health institutions, Eastern Ethiopia. Pan Afr Med J 20 20: 247.
Gebrezgabiher G, Romha G, Ejeta E, Asebe G, Zemene E, Ameni G, 2016. Treatment outcome of tuberculosis patients under directly observed treatment short course and factors affecting outcome in Southern Ethiopia: a five-year retrospective study. PloS One 11: e0150560.
López-Pérez MP, 2017. Informe de Evento Tuberculosis, Colombia. Available at: https://www.ins.gov.co/buscador-eventos/Informesdeevento/TUBERCULOSIS%202017.pdf.
Eventos de Interés en Salud Pública por Subregiones y Municipios , 2017. Antioquia 2007–2016 [Internet]. Secretaría Seccional de Salud y Protección Social de Antioquia. Available at: http://www.dssa.gov.co/index.php/estadisticas/eventos-en-salud-publica.
The World Bank , 2018. Colombia | Data [Internet]. Available at: https://data.worldbank.org/country/colombia.
Ministerio de Salud y Protección Social , 2018. Cifras del Aseguramiento en Salud con Corte Julio de 2018 [Internet]. Available at: https://www.minsalud.gov.co/proteccionsocial/Paginas/cifras-aseguramiento-salud.aspx.
Jacobson KR, Tierney DB, Jeon CY, Mitnick CD, Murray MB, 2010. Treatment outcomes among patients with extensively drug-resistant tuberculosis: systematic review and meta-analysis. Clin Infect Dis 51: 6–14.
World Health Organization , 2011. Guidelines for the Programmatic Management of Drug-Resistant Tuberculosis-2011 update [Internet]. Available at: http://apps.who.int/iris/bitstream/10665/44597/1/9789241501583_eng.pdf.
Ministerio de Salud y Protección Social , 2015. Circular Externa 0007 de 2015: Actualización de los Lineamientos para el Manejo Programático de Tuberculosis y lepra en Colombia [Internet]. Available at: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/circular-externa-0007-de-2015.pdf.
World Health Organization , 2013. Definitions and Reporting Framework for Tuberculosis – 2013 Revision. Geneva, Switzerland: WHO Publications, 1–47.
Castro AF, Arteaga NG, Llinás G, Mora DA, Rueda-Gallardo JA, Villamil MA, 2015. Definición de Categorías de Ruralidad. Departamento Nacional De Planeación. Available at: https://ideas.repec.org/p/col/000118/013652.html.
Honaker J, King G, Blackwell M, 2011. Amelia II: a program for missing data. J Stat Softw 45: 1–47.
Mansournia MA, 2018. Population attributable fraction. BMJ 360: k757. Available at: https://www.bmj.com/content/360/bmj.k757.
Hosmer D, Lemeshow S, 1992. Confidence interval estimation of interaction. Epidemiol Camb Mass 3: 452–456.
Nieto E et al., 2012. Costo-efectividad de un tratamiento antituberculoso alternativo: seguimiento a convivientes residenciales de los pacientes. Rev Panam Salud Pública 32: 178–184.
Martínez-Sánchez LM et al., 2017. Costos de bolsillo de pacientes con diagnóstico de tuberculosis en Colombia. An Fac Med 78: 37--40.
Tanimura T, Jaramillo E, Weil D, Raviglione M, Lönnroth K, 2014. Financial burden for tuberculosis patients in low- and middle-income countries: a systematic review. Eur Respir J 43: 1763–1775.
World Health Organization , 2018. Tracking Universal Health Coverage: First Global Monitoring Report. Available at: http://www.who.int/healthinfo/universal_health_coverage/report/2015/en/.
Woldemichael B, Darega J, Dida N, Tesfaye T, 2021. Treatment outcomes of tuberculosis patients and associated factors in Bale Zone, southeast Ethiopia: a retrospective study. J Int Med Res 49: 300060520984916.
Gadoev J et al., 2015. Factors associated with unfavorable treatment outcomes in new and previously treated TB Patients in Uzbekistan: a five year countrywide study. PloS One 10: e0128907.
Ranzani OT, Carvalho CRR, Waldman EA, Rodrigues LC, 2016. The impact of being homeless on the unsuccessful outcome of treatment of pulmonary TB in São Paulo State, Brazil. BMC Med 14: 41.
Dias M et al., 2017. Tuberculosis among the homeless: should we change the strategy? Int J Tuberc Lung Dis 21: 327–332.
Tesfahuneygn G, Medhin G, Legesse M, 2015. Adherence to anti-tuberculosis treatment and treatment outcomes among tuberculosis patients in Alamata district, northeast Ethiopia. BMC Res Notes 8: 503.
Charoensakulchai S et al., 2021. Six-year trend and risk factors of unsuccessful pulmonary tuberculosis treatment outcomes in Thai Community Hospital. BMC Res Notes 14: 89.
Sreeramareddy CT, Qin ZZ, Satyanarayana S, Subbaraman R, Pai M, 2014. Delays in diagnosis and treatment of pulmonary tuberculosis in India: a systematic review. Int J Tuberc Lung Dis 18: 255–266.
Osei E, Akweongo P, Binka F, 2015. Factors associated with DELAY in diagnosis among tuberculosis patients in Hohoe Municipality, Ghana. BMC Public Health 15: 721.
Cremers AL, Laat MM de, Kapata N, Gerrets R, Klipstein-Grobusch K, Grobusch MP, 2015. Assessing the consequences of stigma for tuberculosis patients in urban Zambia. PloS One 10: e0119861.
Rodríguez DA et al., 2016. Monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in Colombia. Rev Panam Salud Publica Pan Am J Public Health 39: 12–18.
Cai J, Wang X, Ma A, Wang Q, Han X, Li Y, 2015. Factors associated with patient and provider delays for tuberculosis diagnosis and treatment in Asia: a systematic review and meta-analysis. PloS One 10: e0120088.
Bogale S, Diro E, Shiferaw AM, Yenit MK, 2017. Factors associated with the length of delay with tuberculosis diagnosis and treatment among adult tuberculosis patients attending at public health facilities in Gondar town, northwest, Ethiopia. BMC Infect Dis 17: 145.
Acharya PR, D’Souza M, Sahoo RC, 2017. Tuberculosis knowledge and attitude in aspiring doctors and nurses – is it time for our TB teaching methods to evolve? Indian J Tuberc 64: 20–25.
Tlale L et al., 2016. Factors influencing health care workers’ implementation of tuberculosis contact tracing in Kweneng, Botswana. Pan Afr Med J 24: 229. Available at: http://www.panafrican-med-journal.com/content/article/24/229/full/.
Oliveira RCC et al., 2015. Speeches of managers about the policy of the directly observed treatment for tuberculosis. Rev Bras Enferm 68: 1069–1077.
Anticona Huaynate CF et al., 2015. Diagnostics barriers and innovations in rural areas: insights from junior medical doctors on the frontlines of rural care in Peru. BMC Health Serv Res 15: 454.
Purohit MR, Sharma M, Rosales-Klintz S, Lundborg CS, 2015. ‘Multiple-test’ approach to the laboratory diagnosis of tuberculosis-perception of medical doctors from Ujjain, India. BMC Infect Dis 15: 322.
Hernández JMR, Rubiano DPR, Barona JCC, 2015. Barreras de acceso administrativo a los servicios de salud en población Colombiana, 2013. Ciênc Saúde Coletiva 20: 1947–1958.
Carvajal-Barona R, Tovar-Cuevas LM, Aristizábal-Grisales JC, Varela-Arévalo MT, 2012. Barreras asociadas a la adherencia al tratamiento de tuberculosis en Cali y Buenaventura, Colombia, 2012. Rev Gerenc Políticas Salud 16: 68–84.
Souza FBA de, Villa TCS, Cavalcante SC, Ruffino Netto A, Lopes LB, Conde MB, 2007. Peculiarities of tuberculosis control in a scenario of urban violence in a disadvantaged community in Rio de Janeiro, Brazil. J Bras Pneumol 33: 318–322.
Sariem CN, Odumosu P, Dapar MP, Musa J, Ibrahim L, Aguiyi J, 2020. Tuberculosis treatment outcomes: a fifteen-year retrospective study in Jos-North and Mangu, Plateau State, North—Central Nigeria. BMC Public Health 20: 1224.
Mundra A, Deshmukh PR, Dawale A, 2017. Magnitude and determinants of adverse treatment outcomes among tuberculosis patients registered under Revised National Tuberculosis Control Program in a Tuberculosis Unit, Wardha, Central India: a record-based cohort study. J Epidemiol Glob Health 7: 111–118.
Bartholomay P et al., 2016. Quality of tuberculosis care at different levels of health care in Brazil in 2013. Rev Panam Salud Pública 39: 3–11.
Allareddy V, Rampa S, Allareddy V, Nalliah RP, 2017. Tuberculosis management continues to utilize a large amount of hospital resources in the United States. Clin Respir J 11: 21–27.
Fang X-H et al., 2017. Effect of short message service on management of pulmonary tuberculosis patients in Anhui Province, China: a prospective, randomized, controlled study. Med Sci Monit 23: 2465–2469.
Rudgard WE et al., 2017. Comparison of two cash transfer strategies to prevent catastrophic costs for poor tuberculosis-affected households in low- and middle-income countries: an economic modelling study. PLOS Med 14: e1002418.
Ukwaja KN, Alobu I, Mustapha G, Onazi O, Oshi DC, 2017. ‘Sustaining the DOTS’: stakeholders’ experience of a social protection intervention for TB in Nigeria. Int Health 9: 112–117.
Zhang H, Ehiri J, Yang H, Tang S, Li Y, 2016. Impact of community-based DOT on tuberculosis treatment outcomes: a systematic review and meta-analysis. PloS One 11: e0147744.
Fekadu L, Hanson C, Osberg M, Makayova J, Mingkwan P, Chin D, 2017. Increasing access to tuberculosis services in Ethiopia: findings from a patient-pathway analysis. J Infect Dis 216: S696–S701.
Huaynate CFA et al., 2015. Diagnostics barriers and innovations in rural areas: insights from junior medical doctors on the frontlines of rural care in Peru. BMC Health Serv Res 15: 454.
Hanson CL, Osberg M, Brown J, Durham G, Chin DP, 2017. Conducting patient-pathway analysis to inform programming of tuberculosis services: methods. J Infect Dis 216: S679–S685.
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Our aim was to identify the risk factors associated with unsuccessful outcomes of tuberculosis (TB) treatment in patients diagnosed between 2014 and 2016 in the 125 municipalities of Antioquia, Colombia. We studied a retrospective cohort of patients with TB diagnosed between 2014 and 2016, from national routine surveillance systems, in 125 municipalities of Antioquia. Factors associated with unsuccessful tuberculosis treatment outcomes (treatment failed, lost to follow up, or death) were identified utilizing a Poisson regression with robust variance. Over 3 years, of the 6,739 drug-susceptible tuberculosis patients, 73.4% had successful treatment and 26.6% unsuccessful outcomes (17% lost to follow up, 8.9% deaths, and 0.7% treatment failures). Patients with subsidized health insurance (Relative risk [RR]: 2.4; 95% CI: 2.1–2.8) and without health insurance (RR: 2.5; 95% CI: 2.1–3.0) had a higher risk for unsuccessful tuberculosis treatment compared to those with contributive health insurance. Other risk factors included age over 15 years, male sex, homelessness, people living with HIV, previous treatment, and primary diagnosis during hospitalization. Protective factors were living in a rural area and extrapulmonary disease. It is important to generate strategies that improves tuberculosis diagnosis in primary healthcare institutions. In addition, it is imperative to initiate new research about the barriers and obstacles related to patients, healthcare workers and services, and the health system, including the analysis of urban violence, to understand why the goal of TB treatment success has not been reached.
Disclaimer: The content of this article does not reflect the official opinion of the Gobernación de Antioquia or Secretaria Seccional de Salud y Protección social de Antioquia. Responsibility for the information and views expressed in this article lies entirely with the authors.
Authors’ addresses: Lizeth Andrea Paniagua-Saldarriaga, Secretaria Seccional de Salud y Protección Social de Antioquia, Medellín, Colombia, E-mail: firstname.lastname@example.org. Daniele Maria Pelissari, National Tuberculosis Program, Ministry of Health, Brasília, Brazil, E-mail: email@example.com. Zulma Vanessa Rueda, Research Department, School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia, and Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada, E-mail: firstname.lastname@example.org.