Treatment outcome of tuberculosis treatment regimens in Kandahar, Afghanistan

Indian J Tuberc. 2020 Jan;67(1):87-93. doi: 10.1016/j.ijtb.2018.10.008. Epub 2018 Nov 7.

Abstract

Background: Tuberculosis (TB) is a chronic disease that mostly affects low-income countries. TB is transmitted through droplet aerosolization from a person with active pulmonary TB. Afghanistan is one of the 22 high TB burden countries where 39,445 people develop this disease and 7840 people die each year. Treatment outcome is one of the best measurements that explain how the current regimen works.

Material and methods: This was a retrospective cohort study, conducted in Kandahar Province, to find out the treatment outcome of anti-TB drugs regimens in TB patients. Data of pulmonary and extra-pulmonary TB patients, who fulfilled the eligible criteria of the study and were treated from 2005 to 2015, was retrieved from their medical record forms.

Results: Among 1000 TB patients, 599 (59.9%) were females and 401 (40.1%) males; most of the patients (678/1000 [67.8%]) were from Kandahar city while 322/1000 (32.2%) were from the other districts of Kandahar. Mean age of the patients were 36.1 years with SD of 19.3 years. Main signs and symptoms of fever, cough, and weight loss were present in 949/1000 (94.9%), 880/1000 (88%), and 544/1000 (54.4%) of the patients, respectively. On first visit 459/1000 (45.9%) patients were sputum AFB (acid fast bacilli) positive. Majority (247/459 [53.8%]) of these patients were AFB 2+. After 2 months of intensive anti-TB treatment, 9/459 (1.9%) patients were still AFB positive (1+). Treatment outcome of these 1000 patients showed that 479 (47.9%) completed the treatment, 298 (29.8%) were cured, 35 (3.5%) failed the anti-TB treatment, while 5 (0.5%) patients died.

Conclusion: This clearly shows that TB is still one of the major threats to the people of Kandahar Province. There are cases of TB who do not respond to the first line regimens of anti-TB drugs advised by WHO and Afghan Ministry of Public Health (MoPH).

Keywords: Afghanistan; Kandahar; Pulmonary; TB; Treatment outcome.

MeSH terms

  • Adolescent
  • Adult
  • Afghanistan / epidemiology
  • Antitubercular Agents / therapeutic use*
  • Cohort Studies
  • Cough / physiopathology
  • Drug Therapy, Combination
  • Duration of Therapy
  • Ethambutol / therapeutic use*
  • Female
  • Fever / physiopathology
  • Humans
  • Isoniazid / therapeutic use*
  • Male
  • Middle Aged
  • Mortality
  • Prognosis
  • Pyrazinamide / therapeutic use*
  • Retreatment
  • Retrospective Studies
  • Rifampin / therapeutic use*
  • Sex Distribution
  • Sputum
  • Treatment Failure
  • Treatment Outcome
  • Tuberculosis, Pulmonary / drug therapy*
  • Tuberculosis, Pulmonary / epidemiology
  • Tuberculosis, Pulmonary / mortality
  • Tuberculosis, Pulmonary / physiopathology
  • Weight Loss
  • Young Adult

Substances

  • Antitubercular Agents
  • Pyrazinamide
  • Ethambutol
  • Isoniazid
  • Rifampin