Mwanzui Faith Muthoki, Karanja Simon, Muriithi Alex Kigundu, Weyenga Herman Owuor
Kenya Medical Training College, Faculty of Public Heath, Deparment of Health Promotion and Community Health, Nairobi, Kenya.
Jomo Kenyatta University of Agriculture and Technology (JKUAT), Kenya, Nairobi, Kenya.
PLOS Glob Public Health. 2025 May 13;5(5):e0004131. doi: 10.1371/journal.pgph.0004131. eCollection 2025.
Tuberculosis (TB) is one of the infectious diseases of public health concern globally. Kenya is ranked 15th among the 22 high TB burden countries worldwide, which collectively contribute to 80% of the world's TB cases. TB Treatment failure is one of the threats to the control of TB. The research aimed at determining affordable predictors of TB treatment failure in a resource limited setting to inform policy in designing public health interventions that are best suited to the country's needs. To determine the predictors of treatment failure among patients with sputum smear positive pulmonary TB attending selected public health facilities in Nairobi Count. Data was abstracted and summarized from both patients and their medical records, focusing on socio-demographic, behavioral, and clinical exposure data. Data was collected from 4 Sub-counties, a total of 21 public health facilities with high case load of pulmonary TB were reached. Utilizing an unmatched case-control design, the study enrolled 81 patients diagnosed with TB treatment failure (cases) and 162 patients who were declared cured after completing their anti-TB treatment (controls. Strengthen contact tracing, screening, and documentation of TB treatment failure cases. Conduct further studies to elucidate the association between HIV and TB treatment failure. The factors significantly associated with treatment failure in this study encompassed prior exposure to first-line anti-Tuberculosis drugs, positive sputum smear at 2 months of treatment, and suboptimal adherence to anti-TB treatment. These findings contribute valuable insights into the identification of simple predictors of TB treatment failure such as utilizing sputum microscopy or gene expert testing at 2 months of treatment to detect individuals at risk and strengthen the implementation of DOT and TB treatment failure contact tracing protocol.
结核病是全球公共卫生关注的传染病之一。肯尼亚在全球22个结核病高负担国家中排名第15位,这些国家的结核病病例占全球的80%。结核病治疗失败是结核病控制的威胁之一。该研究旨在确定资源有限环境下结核病治疗失败的可负担预测因素,为制定最适合该国需求的公共卫生干预措施的政策提供信息。以确定在内罗毕县选定的公共卫生设施就诊的痰涂片阳性肺结核患者中治疗失败的预测因素。从患者及其病历中提取并汇总数据,重点关注社会人口统计学、行为和临床暴露数据。数据来自4个分区,共涉及21个肺结核病例负荷高的公共卫生设施。采用非匹配病例对照设计,该研究纳入了81例被诊断为结核病治疗失败的患者(病例)和162例完成抗结核治疗后被宣布治愈的患者(对照)。加强对结核病治疗失败病例的接触者追踪、筛查和记录。开展进一步研究以阐明艾滋病毒与结核病治疗失败之间的关联。本研究中与治疗失败显著相关的因素包括既往接触一线抗结核药物、治疗2个月时痰涂片阳性以及抗结核治疗依从性欠佳。这些发现为识别结核病治疗失败的简单预测因素提供了有价值的见解,例如在治疗2个月时利用痰涂片显微镜检查或基因专家检测来发现有风险的个体,并加强直接观察治疗(DOT)和结核病治疗失败接触者追踪方案的实施。