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Tuberculosis Treatment Outcome and Predictors in Africa: A Systematic Review and Meta-Analysis

Author

Listed:
  • Melese Yeshambaw Teferi

    (Armauer Hansen Research Institute, Ministry of Health, Addis Ababa P.O. Box 1005, Ethiopia
    These authors contributed equally to the research.)

  • Ziad El-Khatib

    (Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
    These authors contributed equally to the research.)

  • Minyahil Tadesse Boltena

    (Armauer Hansen Research Institute, Ministry of Health, Addis Ababa P.O. Box 1005, Ethiopia)

  • Azeb Tarekegn Andualem

    (Armauer Hansen Research Institute, Ministry of Health, Addis Ababa P.O. Box 1005, Ethiopia)

  • Benedict Oppong Asamoah

    (Department of Clinical Sciences, Social Medicine and Global Health, Lund University, 221 00 Lund, Sweden)

  • Mulatu Biru

    (Armauer Hansen Research Institute, Ministry of Health, Addis Ababa P.O. Box 1005, Ethiopia)

  • Hawult Taye Adane

    (Armauer Hansen Research Institute, Ministry of Health, Addis Ababa P.O. Box 1005, Ethiopia)

Abstract

This review aimed to summarize and estimate the TB treatment success rate and factors associated with unsuccessful TB treatment outcomes in Africa. Potentially eligible primary studies were retrieved from PubMed and Google Scholar. The risk of bias and quality of studies was assessed using The Joanna Briggs Institute’s (JBI) appraisal criteria, while heterogeneity across studies was assessed using Cochran’s Q test and I2 statistic. Publication bias was checked using the funnel plot and egger’s test. The protocol was registered in PROSPERO, numbered CRD42019136986. A total of 26 eligible studies were considered. The overall pooled estimate of TB treatment success rate was found to be 79.0% (95% CI: 76–82%), ranging from 53% (95% CI: 47–58%) in Nigeria to 92% (95% CI: 90–93%) in Ethiopia. The majority of unsuccessful outcomes were attributed to 48% (95% CI: 40–57%) death and 47% (95% CI: 39–55%) of defaulter rate. HIV co-infection and retreatment were significantly associated with an increased risk of unsuccessful treatment outcomes compared to HIV negative and newly diagnosed TB patients with RR of 1.53 (95% CI: 1.36–1.71) and 1.48 (95% CI: 1.14–1.94), respectively. TB treatment success rate was 79% below the WHO defined threshold of 85% with significant variation across countries. Countries need to explore contextual underlining factors and more effort is required in providing TB preventive treatment, improve case screening and linkage for TB treatment among HIV high-risk groups and use confirmatory TB diagnostic modality. Countries in Africa need to strengthen counseling and follow-up, socio-economic support for patients at high risk of loss to follow-up and poor treatment success is also crucial for successful TB control programs.

Suggested Citation

  • Melese Yeshambaw Teferi & Ziad El-Khatib & Minyahil Tadesse Boltena & Azeb Tarekegn Andualem & Benedict Oppong Asamoah & Mulatu Biru & Hawult Taye Adane, 2021. "Tuberculosis Treatment Outcome and Predictors in Africa: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(20), pages 1-15, October.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:20:p:10678-:d:654139
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    References listed on IDEAS

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    1. Narges Alipanah & Leah Jarlsberg & Cecily Miller & Nguyen Nhat Linh & Dennis Falzon & Ernesto Jaramillo & Payam Nahid, 2018. "Adherence interventions and outcomes of tuberculosis treatment: A systematic review and meta-analysis of trials and observational studies," PLOS Medicine, Public Library of Science, vol. 15(7), pages 1-44, July.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Setegn Eshetie & Mucheye Gizachew & Animut Alebel & Dick van Soolingen, 2018. "Tuberculosis treatment outcomes in Ethiopia from 2003 to 2016, and impact of HIV co-infection and prior drug exposure: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-18, March.
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    1. Farman Ullah Khan & Asim ur Rehman & Faiz Ullah Khan & Khezar Hayat & Amjad Khan & Nafees Ahmad & Jie Chang & Usman Rashid Malik & Yu Fang, 2022. "Assessment of Factors Associated with Unfavorable Outcomes among Drug-Resistant TB Patients: A 6-Year Retrospective Study from Pakistan," IJERPH, MDPI, vol. 19(3), pages 1-13, January.

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