Treatment Outcomes among Drug Sensitive Tuberculosis Patients in Tana River County - Kenya, 2014–2017

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Kenya is among 22 high burden countries that together account for 80% of TB cases globally. In 2017, Kenya achieved a treatment success rate (TSR) of 83.2% and cure rate (CR) of 65%. Tana River County had TSR of 85%, CR of 72.5% for 2017 and has not met set targets of 90% TSR and 85% CR over the years. We described treatment outcomes among drug sensitive TB patients.
We reviewed both private and public facility records for Tana River County from the national Electronic TB Patient Management System from 2014–2017. A case was a record of TB confirmed by sputum microscopy, Gene Xpert or culture, or diagnosed clinically. We excluded records of patients with drug resistant TB. We collected socio- demographic and clinical information. Treatment outcomes were classified as complete, cured, died, failed, lost-to- follow-up and not evaluated. We calculated descriptive statistics.
A total of 1,678 records were reviewed; males were 58.6% (983/1,678), median age of patients on treatment was 30.1 years (Range 6 weeks – 99 years), 10.4% (174/1,678) were HIV positive, 86.6% (1453/1,678) were treated successfully, 7% (118/1,678) died, 4.1% (69/1,678) lost-to-follow-up and 2% (34/1,678) not evaluated. Among 773 (46%) bacteriolog- ically confirmed cases; 74.3% (574/773) got cured, 14.1% (109/773) completed treatment without follow-up sputum tests, 4.9% (38/773) died and 3.5% (27/773) lost-to-follow-up. All 174 HIV positive patients were on preventive therapy, 94% (164/174) were on Anti-retroviral Therapy (ART), despite this, 19% (33/174) died. Among the 7% (118/1,678) who died, 25.4% (30/118) received nutritional intervention, 80.5% (95/118) had pulmonary TB and among them 59% (56/95) were clinically diagnosed.
Pulmonary TB may have contributed to most of the deaths. A fifth of the HIV positive cases died despite being on ART. We recommend improved integration of TB treatment with nutrition services and comprehensive HIV care.

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