Differences in the profile and outcomes of treatment between non- retreatment and retreated groups of Tuberculosis patients in Botswana

Abstract

In health sciences, the profile of the studied population has important implications because of the need to take into account personnel characteristics of patients in devising and applying the findings for policy and treatment purposes.  This study was conducted to establish the profile of retreatment tuberculosis patients as well as the outcomes of treatment in these patients in comparison to non-retreatment patients in Kanye District in Botswana.

This study was conducted by means of a review of records of tuberculosis patients treated in Kanye District of Botswana. Eligible patients were identified by using TB (tuberculosis) register available at each clinic and the databases in the electronic TB registers at the district level. Records of all patients that were treated at the study sites were included.

Overall, a total of 1209 patients were treated for TB during the study period. Of this, 99 were retreatment cases, yielding a prevalence of 9.09%.  The mean age of the study population was 46.63 (± 3) years; the majority of them were males (51.69%) and 40 years old or less (57.65%). Compared to the non-retreatment cases, patients retreated or retreatment cases were significantly older than 40 years old (67.3% versus 58.9%, p=0.00009) and male (72.4% versus 54.2%, p=0.00001). The outcomes of treatment in retreatment cases were poorer as compared to non-retreatment cases in that the overall treatment success was 52.03% versus 75.3%; non-retreatment cases were at least two times more likely to be successfully treated than retreatment cases (OR=2.35 [1.51, 3.66], p=0.00017).

In conclusion, non-retreatment cases differed from retreatment cases not only in terms of their socio-demographic characteristics but also with regard to treatment outcomes as retreated cased performed poorly in terms of treatment success, failure to treatment and case fatality rates.  Several interventions should be contemplated based on the specific contexts of patients in order to improve outcomes of treatment in retreatment cases.