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Expert Rev Respir Med ; 12(11): 979-987, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30198358

RESUMEN

OBJECTIVES: Optimal treatment success rates are critical to end tuberculosis in Namibia. Despite the scale-up of high quality directly observed therapy short-course strategy (DOTS) in Namibia, treatment success falls short of the global target of 90%. The objective of this study was to ascertain the predictors of treatment success rates under DOTS in Namibia to provide future direction. METHODS: A nation-wide comparative analysis of predictors of treatment success was undertaken. Tuberculosis cases in the electronic tuberculosis register were retrospectively reviewed over a 10-year period, 2004-2016. The patient, programmatic, clinical, and treatment predictors of treatment success were determined by multivariate logistic regression modeling using R software. RESULTS: 104,603 TB cases were registered at 300 DOTS sites in 37 districts. The 10-year period treatment success rate was 80%, and varied by region (77.2%-89.2%). The patient's sex and age were not significant predictors. The independent predictors for treatment success as were: Region of DOTS implementation (p=0.001), type of directly observed treatment (DOT) supporter (p<0.001), sputum conversion at 2 months (p=0.013), DOT regimen (p<0.001), cotrimoxazole prophylaxis (p=0.002), and HIV co-infection (p=0.001). CONCLUSION: Targeted programmatic, clinical and treatment interventions are required to enhance DOTS treatment success in Namibia. These are now ongoing.


Asunto(s)
Terapia por Observación Directa , Tuberculosis/tratamiento farmacológico , Tuberculosis/epidemiología , Adulto , Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Antituberculosos/uso terapéutico , Coinfección/epidemiología , Femenino , Infecciones por VIH/epidemiología , Humanos , Masculino , Namibia/epidemiología , Sistema de Registros , Estudios Retrospectivos , Resultado del Tratamiento , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico
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