Risk factors for tuberculosis treatment failure among pulmonary tuberculosis patients in four health regions of Burkina Faso, 2009: case control study.
BACKGROUND
In Burkina Faso, the tuberculosis (TB) treatment failure rate increased from 2.5% in 2000 to 8.3% in 2006. The risk factors for TB treatment failure in the country are not well known. The study aims to determine the risk factors for treatment failure among pulmonary tuberculosis patients in four health region of Burkina Faso and to recommend appropriate interventions.


METHODS
A case control study was conducted among pulmonary TB patients who began TB treatment in 2009. A case was any patient who remained smear-positive at fifth month of TB treatment and a control was a patient who tested smear-negative at fifth month of treatment. A structured questionnaire was administered to one hundred cases and one hundred controls to collect information on exposure factors. Odds ratio were calculated using bivariate and multivariate analysis to determine the association between exposures and outcome.


RESULTS
Multivariate analysis showed that independent risk factors for TB treatment failure were fail to take TB drugs for more than 14 consecutive days (OR = 18.53; 95% CI:4.56 - 75.22), sputum smear-positive at two months of treatment (OR = 11.52; 95%CI:5.18-25.60), existence of comorbidity (OR = 5.74; 95%CI:1.69-19.44), and use of traditional medicines or herbs (OR = 2.97; 95%CI:1.12-7.85).


CONCLUSIONS
Early identification of patients with the above risk factors for intense case management will improve TB treatment outcome. Patient with smear positive at 2nd(nd) month of treatment require more intense follow-up, and involving traditional healers who provide traditional medicines or herbs in the educational programme on TB are required. The national referral laboratory capacity needs to be strengthened to do drug susceptibility testing and routine drug monitoring on cases of non conversion at 2(nd) month of treatment.
South Africa Field Epidemiology and Laboratory Training Programme, South Africa ; School of Health System and Public health: University of Pretoria, South Africa ; University of Ouagadougou, Burkina Faso.
Bernard
B
Sawadogo
South Africa Field Epidemiology and Laboratory Training Programme, South Africa ; School of Health System and Public health: University of Pretoria, South Africa.
Khin San
KS
Tint
South Africa Field Epidemiology and Laboratory Training Programme, South Africa.
Mufuta
M
Tshimanga
South Africa Field Epidemiology and Laboratory Training Programme, South Africa.
Lazarus
L
Kuonza
University of Ouagadougou, Burkina Faso.
Laurent
L
Ouedraogo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002050:Burkina Faso; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D017211:Treatment Failure; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*; D055815:Young Adult
D000995:Antitubercular Agents
Pulmonary tuberculosis; risk factors; treatment failure