Prevalence and determinants of unsuccessful tuberculosis treatment outcome among drug-susceptible tuberculosis patients in Rwanda

Abstract

Abstract Background Despite the effective diagnostic tools and treatment availability, tuberculosis (TB) remains the top cause of death as a single infectious disease worldwide. However, there is limited evidence on determinants of unsuccessful TB treatment outcome among drug-susceptible TB (DSTB) patients in Rwanda. Therefore, this study aimed to determine the determinants of unsuccessful TB treatment outcomes among adult DSTB patients in Rwanda. Methods A retrospective study was conducted among DSTB patients registered in the national electronic TB reporting system by all health facilities countrywide from July 2019 to June 2022. Patients aged 15 years and above with recorded treatment outcomes were included in the study. Multivariable logistic regression was performed using STATA 17 to determine factors associated with unsuccessful TB treatment outcomes. Adjusted odds ratio (OR), 95% confidence interval (CI), and p-value < 0.05 were reported. Results This study included 14,548 patients. Of them, 1527 (10.5%) patients had unsuccessful treatment outcome. In multivariate logistic regression analysis, not receiving ART (AOR = 4.3, 95% C.I:2.9–6.3), history of first-line TB treatment failure (AOR = 2.9, 95% C.I: 1.0-8.1), not being followed-up by community health workers (CHWs) (AOR = 1.6, 95% C.I:1.2–2.1), BMI < 18.5 at treatment initiation (AOR = 1.4, 95% C.I:1.1–1.8), extra-pulmonary TB (AOR = 0.5, 95% C.I:0.4–0.7), and clinically diagnosed (AOR = 0.4, 95% C.I:0.3–0.6), were found to be significantly associated with unsuccessful TB treatment outcome. Conclusion The study showed that unsuccessful TB treatment outcome among DSTB patients was low compared to studies conducted in other settings. This highlights a good progress in fighting against TB, but targeted strategies are still needed to address the remaining gap.