Treatment success and associated factors among drug-susceptible TB patients

Who

• Study population: Individuals diagnosed with drug-susceptible tuberculosis (TB) and initiated on TB treatment.

• Sample size: 1,009 individuals included in final analysis (from 1,062 records).

• Demographics:

  • Median age: 45 years (IQR 28–60)

  • 9.5% <15 years; 48.1% aged 15–49 years

  • 52.9% male

  • 30.9% HIV-positive

• Exclusions: Individuals with incomplete key data, unknown HIV status, or rifampicin-resistant TB.

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What

• Focus: Determination of TB treatment success rate (TSR) and factors associated with treatment success among drug-susceptible TB patients.

• Key findings:

  • Overall TSR was 91.9% (95% CI: 90.0–93.4%), exceeding prior regional estimates and aligning with the national target.

  • Treatment success comprised 47.4% treatment completion and 44.5% cure.

  • Unsuccessful outcomes included death (5.1%), lost to follow-up (0.3%), and not evaluated (2.8%).

• Associated factors: Older age (>49 years), male sex, and HIV positivity were associated with lower treatment success.

• Implications: Despite a historically lower TSR in the Teso region, current outcomes are strong; however, targeted interventions are needed for older adults, males, and people living with HIV to sustain progress toward the End TB Strategy by 2030.

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When

• TB treatment period reviewed: 1 October 2021 – 30 December 2023

• Data collection period: 1 March 2025 – 28 March 2025

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Where

• Setting: Five large public health facilities in the Teso region, Northeastern Uganda.

• Districts: Kumi, Serere, Bukedea, and Ngora

• Facilities: Atutur Hospital, Kumi HC IV, Serere HC IV, Bukedea HC IV, and Ngora HC IV

• Context: Predominantly rural population with subsistence farming livelihoods and low HIV prevalence relative to the national average.

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Why

• The Teso region has a high TB burden but historically suboptimal TSR compared to national averages.

• Understanding drivers of treatment success and failure in rural, resource-limited settings is essential for designing targeted interventions and achieving global TB elimination goals.

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How

• Study design: Retrospective quantitative study.

• Data source: TB treatment registers from selected health facilities.

• Outcome definition:

  • Treatment success: Cure + treatment completion (WHO criteria).

  • Unsuccessful outcomes: Death, loss to follow-up, treatment failure, or not evaluated.

• Independent variables: Age, sex, HIV status, TB classification, treatment category, referral source, GeneXpert access, and nutritional status (MUAC).

• Analysis:

• Bivariate analysis for associations.

• Modified Poisson regression with robust standard errors to estimate adjusted prevalence ratios (aPR), chosen due to outcome prevalence >10%.

Source: Ssentongo, S.M., Oryokot, B., Opito, R., Ochieng, G., Sekiranda, P., Bakashaba, B. and Mugisha, K., 2025. Treatment success and associated factors among drug-susceptible tuberculosis patients in Teso region, Uganda: a retrospective study. Therapeutic Advances in Infectious Disease, 12, pp.1-12.