title: Risk factors for unsuccessful tuberculosis treatment outcome (failure, default and death) in public health institutions, Eastern Ethiopia.
abstract: BACKGROUND
  Unsuccessful TB treatment outcome is a serious public health concern. It is compelling to identify, and deal with factors determining unsuccessful treatment outcome. Therefore, study was aimed to determine pattern of unsuccessful TB treatment outcome and associated factors in eastern Ethiopia.
  
  
  METHODS
  A case control study was used. Cases were records of TB patients registered as defaulter, dead and/or treatment failure where as controls were those cured or treatment complete. Multivariate logistic regression models were used to derive adjusted odds ratios (OR) at 95% CI to examine the relationship between the unsuccessful TB treatment outcome and patients' characteristics.
  
  
  RESULTS
  A total of 990 sample size (330 cases and 660 controls) were included. Among cases (n = 330), majority 212(64.2%) were because of death, 100(30.3%) defaulters and 18(5.5%) were treatment failure. Lack of contact person(OR = 1.37; 95% CI 1.14-2.9, P, .024), sputum smear negative treatment category at initiation of treatment (OR = 1.8; 95% CI 1.3-5.5,P, .028), smear positive sputum test result at 2(nd) month after initiation treatment (OR = 14; 95% CI 5.5-36, P,0.001) and HIV positive status (OR = 2.5; 95% CI 1.34-5.7, P, 0.01) were independently associated with increased risk of unsuccessful TB treatment outcome.
  
  
  CONCLUSIONS
  Death was the major cause of unsuccessful TB treatment outcome. TB patients do not have contact person, sputum smear negative treatment category at initiation of treatment, smear positive on 2(nd) month after treatment initiation and HIV positive were factors significantly associated unsuccessful treatment outcome. TB patients with sputum smear negative treatment category, HIV positive and smear positive on 2(nd) nd month of treatment initiation need strict follow up throughout DOTs period.
authors.affiliation: Department of Public Health, College of Health and Medical Sciences, Haramaya University Harar, Ethiopia.
authors.forename: Tariku Dingeta
authors.initials: TD
authors.lastname: Amante
authors.affiliation: School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
authors.forename: Tekabe Abdosh
authors.initials: TA
authors.lastname: Ahemed
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D023801:Directly Observed Therapy; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013183:Sputum; D017211:Treatment Failure; D014376:Tuberculosis / Q000188:drug therapy* / Q000401:mortality*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: Unsuccessful TB treatment outcomes; death; sputum smear negative