Factor associated with time to successful treatment with newly diagnosed pulmonary TB in Kalasin province

Abstract

The purpose of this study was to study the factors associated with the time from the start of treatment to the completion of treatment of new pulmonary tuberculosis patients in Kalasin Province. This is a retrospective study. From secondary data of 1,092 patients registered for treatment in the NTIP program in 2022, the time from treatment start to completion was estimated using the Kaplan-Meier method, and factors related to the time from treatment were analyzed. Until successful treatment using the Cox proportional hazard model. Results of the study: A total of 1,092 new pulmonary tuberculosis patients studied were found to have successful treatment results. (Complete treatment and cured) 82.1 percent. Treatment was unsuccessful, 17.9 percent. Median duration of successful treatment overall was 186 days (95%CI 184-187 days). From analysis of duration of successful treatment in subgroups according to Factors: gender, age, age group, home district, prisoner, sputum test results (AFB) when first diagnosed, co-morbidities: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis, high blood pressure. and HIV infection using the Kaplan-Meier method. It was found that in the home district, prisoners had high blood pressure. and had immunodeficiency caused by HIV. There were differences between the successful treatment group and the unsuccessful treatment group. The results of the analysis of the Cox proportional hazard model found factors that were significantly related to the time from the start of treatment until treatment was completed (p-value< 0.05), including district according to domicile, age group, and HIV infection. The difference was statistically significant at the 0.05 level between the group that was successfully treated and the group that was unsuccessful. When comparing successful treatment in each district, it was found that the district with the shortest successful treatment period was Khao Wong District, followed by Kuchinarai, Yang Talad, Namon, Sahatsakhan and Huai Phueng districts, respectively. Pulmonary tuberculosis patients aged 60 years and over. There is a 1.176 times faster chance of successful treatment than pulmonary tuberculosis patients under 60 years of age. For pulmonary tuberculosis patients who are also infected with HIV, there is a faster chance of successful treatment than pulmonary tuberculosis patients who are not infected with HIV. 1.512 times. Therefore, there are recommendations from the results of this study, including the development of guidelines for directing drug intake (DOT) in a participatory manner among tuberculosis patients who do not have congenital diseases or who are of working age, as well as extracting lessons learned from caring for patients. tuberculosis patients in districts with a short period of successful treatment (such as Khao Wong District, Kuchinarai District) to develop guidelines for tuberculosis surveillance, prevention, and control.