Trends of Tuberculosis Treatment Outcomes of Notified Cases in Three Refugee Camps in Sudan: A Four-year Retrospective Analysis, 2014–2017
الملخص
Background: Refugees are vulnerable to tuberculosis (TB) infection. Tracking of
program performance is needed to improve TB care and prevention. The objective
of this study was to assess the trends of TB treatment outcomes of notified cases in
three refugee camps in Sudan from 2014 to 2017.
Methods: This study was a historical cohort study. Sex, age, type of TB, TB patient
category, and treatment outcome of all TB cases registered in three refugee camps
(Al Kashafa, Shagarab, Wadsherify) from January 1, 2014 to December 31, 2017 were
collected from the TB register. Multivariable logistic regression was performed to
explore factors for unsuccessful TB treatment.
Results: A total of 710 TB cases of which 53.4% were men, 22.1% children (<15
years), and 36.2% extrapulmonary TB (EPTB) were registered. Overall, the TB treatment
success rate was 75.7% with a declining trend from 86.2% in 2015 to 63.5% in 2017. On
average, 11.4% were lost to follow-up (LTFU), 6.6% died, 5.9% were not evaluated, and
in 0.3% the treatment failed. Being 15–24 years old and having EPTB were significantly
associated with unsuccessful treatment outcome.
Conclusion: The treatment success rate in the refugee camp in 2017 (63.5%) was far
lower than the national treatment success rate (78%) and the End TB global target
(≥90%) that needs to be improved. LTFU, died, and not evaluated outcomes were high
which indicated the necessity to improve the TB treatment program.
المراجع
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[21] Sukrakanchana-Trikham, P., Pue´chal, X., Rigal, J., et al. (1992). 10-year assessmentof treatment outcome among Cambodian refugees with sputum smear-positivetuberculosis in Khao-l-Dang, Thailand. Tubercle and Lung Disease, vol. 73, no. 6,pp. 384–387.
[22] Legesse, T., Admenur, G., Gebregzabher, S., et al. (2021). Tuberculosis (TB) inthe refugee camps in Ethiopia: trends of case notification, profile, and treatmentoutcomes, 2014 to 2017. BMC Infectious Diseases, vol. 21, article 139.
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[24] Dogru, S. and Doner, P. (2017). Frequency and outcomes of new patients withpulmonary tuberculosis in Hatay province after Syrian civil war. Indian Journal ofTuberculosis, vol. 64, no. 2, pp. 83–88.
[25] Sukrakanchana-Trikham P, Pue´chal X, Rigal J, Rieder HL. (1992).10-year assessmentof treatment outcome among Cambodian refugees with sputum smear-positivetuberculosis in Khao-l-Dang, Thailand. Tuber Lung Dis. vol. 73, no. 6, pp 38–47.
[26] Minetti, A., Camelique, O., Hsa Thaw, K., et al. (2010). Tuberculosis treatment ina refugee and migrant population: 20 years of experience on the Thai-Burmeseborder. International Journal of TuberculosisandLungDisease,vol.14,no.12,pp.1589–1595.
[27] Rutta, E., Kipingili, R., Lukonge, H., et al. (2001). Treatment outcome among Rwandanand Burundian refugees with sputum smear-positivetuberculosis in Ngara, Tanzania.International Journal of Tuberculosis and Lung Disease, vol. 5, no. 7, pp. 628–632.
[28] Boyd, A. T., Cookson, S. T., Almashayek, I., et al. (2019). An evaluation of a tuberculosiscase-finding and treatment program among Syrian refugees—Jordan and Lebanon,2013–2015. BMC Infectious Diseases, vol. 13, article 32.
[29] Ministry of Health (MOH), Sudan. (2018). National TB Management Guideline. MOH,Sudan.
[30] WHO. (2013). Definitions and Reporting Framework for Tuberculosis – 2013 Revision.
[31] Hassanain, S. A., Edwards, J. K., Venables, E., et al. (2018). Conflict and tuberculosisin Sudan: a 10-year review of the National Tuberculosis Programme, 2004–2014.Conflict and Health, vol. 12, article 18.
[32] Yang, Z., Kong, Y., Wilson, F., et al. (2004). Identification of risk factors forextrapulmonary tuberculosis. Clinical Infectious Diseases, vol. 38, no. 2, pp. 199–205.
[33] Zhang, X., Andersen, A. B., Lillebaek, T., et al. (2011). Effect of sex, age, and race onthe clinical presentation of tuberculosis: a 15-year population-based study. AmericanJournal of Tropical Medicine and Hygiene, vol. 85, no. 2, pp. 285–290.
[34] Manabe, Y. C., Dannenberg, A. M., Jr., Tyagi, S. K., et al. (2003). Different strains ofMycobacterium tuberculosis cause various spectrums of disease in the rabbit modelof tuberculosis. Infection and Immunity, vol. 71, no. 10, pp. 6004–6601.
[35] Dogar, O. F., Shah, S. K., Chughtai, A. A., et al. (2012). Gender disparity in tuberculosiscases in eastern and western provinces of Pakistan. BMC Infectious Diseases, vol.12, article 244.
[36] Severo, N. P., Leite, C. Q., Capela, M. V., et al. (2007). Clinical and demographiccharacteristics of patients hospitalized with tuberculosis in Brazil between 1994 and2004. Jornal Brasileiro de Pneumologia, vol. 33, no. 5, pp. 565–571.
[2] World Health Organization (2015). The End TB Strategy. Geneva: World HealthOrganization. Retrieved from: https://www.who.int/tb/strategy/end-tb/en/
[3] Kimbrough, W., Saliba, V., Dahab, M., et al. (2012). The burden of tuberculosis incrisis-affected populations: a systematic review. Lancet Infectious Diseases, vol. 12,no. 12, pp. 950–965.
[4] WHO. (2016, May 10–11). Interregional Workshop for Tuberculosis Control and CareAmong Refugees and Migrant Populations. Catania, Italy: WHO. Retrieved from:http://www.euro.who.int/__data/assets/pdf_file
[5] Nuzzo, J. B., Golub, J. E., Chaulk, P., et al. (2015). Postarrival tuberculosis screening
of high-risk immigrants at a local health department. American Journal of PublicHealth, vol. 105, no. 7, pp. 1432–1438.
[6] Greenaway, C., Sandoe, A., Vissandjee, B., et al. (2011). Tuberculosis: evidence reviewfor newly arriving immigrants and refugees. CMAJ, vol. 183, no. 12, pp. E939–E951.
[7] Acosta, C. D. (2014). Conflict and drug-resistant tuberculosis in Ukraine. Lancet, vol.384, no. 9953, pp. 1500–1501.
[8] Ejeta, E., Beyene, G., Balay, G., et al. (2018). Factors associated with unsuccessfultreatment outcome in tuberculosis patients among refugees and their surroundingcommunities in Gambella Regional State, Ethiopia. PLoS ONE, vol. 13, no. 10, p.e0205468.
[9] Dogru, S. and Doner, P. (2017). Frequency and outcomes of new patients withpulmonary tuberculosis in Hatay province after Syrian civil war. Indian Journal ofTuberculosis, vol. 64, no. 2, pp. 83–88.
[10] Njuki, C. and Abera, W. (2018). Forced displacement and mixed migration challengesin the IGAD region. GREAT Insights Magazine, vol. 7, no. 1.
[11] United Nations High Commissioner for Refugees (UNHCR). (2019). Global Trends:Forced Displacement in 2018. Geneva: UNHCR. Retrieved from: https://www.unhcr.org/5d08d7ee7.pdf
[12] WHO. (1997). Tuberculosis Control in Refugee Situations: An Inter-agencyField Manual. WHO. Retrieved from: https://www.unhcr.org/publications/operations/3c47f5eb5/tuberculosis-control-refugee-situations-inter-agency-field-manual.html
[13] Proença, R., Souza, F. M., Bastos, M. L., et al. (2020). Active and latent tuberculosis
in refugees and asylum seekers: a systematic review and meta-analysis. BMC PublicHealth, vol. 20, article 838.
[14] World Health Organization, International Organization for Migration, and Ministry ofHealth of Lebanon. (2015). Joint Review of the National Tuberculosis Programme ofLebanon.
[15] United Nations High Commissioner for Refugees (UNHCR). (2013). Public HealthStrategy for Tuberculosis among Syrian Refugees in Jordan.
[16] World Health Organization. (2006). Stop TB Strategy. Geneva: World HealthOrganization.[17] UNHCR. (2014–2020). Global Focus, End Year Report, 2014–2020. Retrieved from:https://reporting.unhcr.org/node/2535
[18] Centers for Disease Control. (1992). Famine-affected, refugee, and displacedpopulations: recommendations for public health issues. MMWR, vol. 41, no. RR-13.
[19] World Health Organization (WHO). (2018). Compendium of WHO Guidelines andAssociated Standards: Ensuring Optimum Delivery of the Cascade of Care forPatients with Tuberculosis (2nd ed.). Geneva: WHO.
[20] Vo, L. N. Q., Codlin, A. J., Forse, R. J., et al. (2020). Tuberculosis among economicmigrants: across-sectional study of the risk of poor treatment outcomes and impact ofa treatment adherence intervention among temporary residents in an urban districtin Ho Chi Minh City, Vietnam. BMC Infectious Diseases, vol. 20, no. 1, p. 134.
[21] Sukrakanchana-Trikham, P., Pue´chal, X., Rigal, J., et al. (1992). 10-year assessmentof treatment outcome among Cambodian refugees with sputum smear-positivetuberculosis in Khao-l-Dang, Thailand. Tubercle and Lung Disease, vol. 73, no. 6,pp. 384–387.
[22] Legesse, T., Admenur, G., Gebregzabher, S., et al. (2021). Tuberculosis (TB) inthe refugee camps in Ethiopia: trends of case notification, profile, and treatmentoutcomes, 2014 to 2017. BMC Infectious Diseases, vol. 21, article 139.
[23] Shingadia, D. and Novelli, V. (2003). Diagnosis and treatment of tuberculosis inchildren. Lancet Infectious Diseases, vol. 3, no. 10, pp. 624–632.
[24] Dogru, S. and Doner, P. (2017). Frequency and outcomes of new patients withpulmonary tuberculosis in Hatay province after Syrian civil war. Indian Journal ofTuberculosis, vol. 64, no. 2, pp. 83–88.
[25] Sukrakanchana-Trikham P, Pue´chal X, Rigal J, Rieder HL. (1992).10-year assessmentof treatment outcome among Cambodian refugees with sputum smear-positivetuberculosis in Khao-l-Dang, Thailand. Tuber Lung Dis. vol. 73, no. 6, pp 38–47.
[26] Minetti, A., Camelique, O., Hsa Thaw, K., et al. (2010). Tuberculosis treatment ina refugee and migrant population: 20 years of experience on the Thai-Burmeseborder. International Journal of TuberculosisandLungDisease,vol.14,no.12,pp.1589–1595.
[27] Rutta, E., Kipingili, R., Lukonge, H., et al. (2001). Treatment outcome among Rwandanand Burundian refugees with sputum smear-positivetuberculosis in Ngara, Tanzania.International Journal of Tuberculosis and Lung Disease, vol. 5, no. 7, pp. 628–632.
[28] Boyd, A. T., Cookson, S. T., Almashayek, I., et al. (2019). An evaluation of a tuberculosiscase-finding and treatment program among Syrian refugees—Jordan and Lebanon,2013–2015. BMC Infectious Diseases, vol. 13, article 32.
[29] Ministry of Health (MOH), Sudan. (2018). National TB Management Guideline. MOH,Sudan.
[30] WHO. (2013). Definitions and Reporting Framework for Tuberculosis – 2013 Revision.
[31] Hassanain, S. A., Edwards, J. K., Venables, E., et al. (2018). Conflict and tuberculosisin Sudan: a 10-year review of the National Tuberculosis Programme, 2004–2014.Conflict and Health, vol. 12, article 18.
[32] Yang, Z., Kong, Y., Wilson, F., et al. (2004). Identification of risk factors forextrapulmonary tuberculosis. Clinical Infectious Diseases, vol. 38, no. 2, pp. 199–205.
[33] Zhang, X., Andersen, A. B., Lillebaek, T., et al. (2011). Effect of sex, age, and race onthe clinical presentation of tuberculosis: a 15-year population-based study. AmericanJournal of Tropical Medicine and Hygiene, vol. 85, no. 2, pp. 285–290.
[34] Manabe, Y. C., Dannenberg, A. M., Jr., Tyagi, S. K., et al. (2003). Different strains ofMycobacterium tuberculosis cause various spectrums of disease in the rabbit modelof tuberculosis. Infection and Immunity, vol. 71, no. 10, pp. 6004–6601.
[35] Dogar, O. F., Shah, S. K., Chughtai, A. A., et al. (2012). Gender disparity in tuberculosiscases in eastern and western provinces of Pakistan. BMC Infectious Diseases, vol.12, article 244.
[36] Severo, N. P., Leite, C. Q., Capela, M. V., et al. (2007). Clinical and demographiccharacteristics of patients hospitalized with tuberculosis in Brazil between 1994 and2004. Jornal Brasileiro de Pneumologia, vol. 33, no. 5, pp. 565–571.
منشور
2021-08-21
القسم
Original Articles
