Predictors of initial treatment failure among pulmonary tuberculosis patients in two Specialized Hospitals in Afghanistan

Abstract

Introduction: Treatment failure of pulmonary tuberculosis patients is defined as a patient who has sputum smear (SS) positive at 5 months or later after the initiation of anti TB treatment. Tuberculosis treatment failure increased the risk of spreading infection among people that lead to increased mortality and expenditures. A cross sectional study carried out in tow specialized hospital of Afghanistan, to identify the factors associated with TB treatment failure and usage of these factors to predict those who are at high risk of pulmonary tuberculosis treatment failure. Objectives: To identify the predictors and factors which are associated with treatment failure among pulmonary tuberculosis patients. Methodology: A quantitative cross- sectional study involving 150 participants. The study was conducted in two different specialized hospitals in Kabul and Paktia, Afghanistan with advance technology, facilities and medical experts. The convenience sampling method was used for selecting sample. The standard questionnaire (Moresky scale, treatment adherence scale and personal developed question regarding to the situation of the state) was the data collecting tool. Analysis was performed using SPSS. Descriptive analysis and chi-square test was used to analyze data and results were presented in tables, charts and figures. Results: Female were more likely to be affected than male. Failure rate was seen more among smoker, participant from rural area and among participant with larger family members. The study found association of age of participants, herbal/traditional medicine use and pulmonary tuberculosis treatment failure. Although other factors like dealing of health professional with patients, waiting time to receive the medicine, distance to clinic, irregular drug used were essential factor for drug failure but it did not show statically significant association. Conclusion: the study showed those who miss clinical appointment, have contact with TB patients, smokers, people from rural area, people using herbal/traditional medicine for tuberculosis treatments and those who were face security and restricted family or social issues were statistically significant factors which that are associated with pulmonary tuberculosis treatment failure. Key words: Pulmonary Tuberculosis, Predictors, Treatment failure