Introduction: Despite the availability of highly effective treatment for tuberculosis (TB), patients with TB may experience a relapse, which can be either a result of the disease reactivating or a new episode induced by reinfection. In Malaysia, there has been a noticeable rise in relapse TB cases, with a substantial rate of unsuccessful treatment outcomes among this population. This study seeks to examine the trends of unsuccessful treatment outcomes in relapse TB patients and explore how factors such as sociodemographic characteristics, TB disease profile, TB treatment profile, and comorbidities contribute to the outcomes.
Materials And Methods: This is a retrospective cohort study utilising secondary data from the National Tuberculosis Registry (NTBR). The study was conducted in Selangor among relapsed TB patients who were registered in NTBR from 1 January 2015 to 31 December 2019. TB disease profile, TB treatment profile, comorbidities, and sociodemographic data were examined. The determinants of unsuccessful treatment outcomes among relapsed TB patients were identified using multiple (binary) logistic regression analyses.
Results: 896 patients who experienced relapsed tuberculosis were included in this study. 32.25% were reported to have unsuccessful treatment outcomes. Multiple (binary) logistic regression revealed that the absence of sputum smear examination at 5 months and beyond was a determinant of unsuccessful treatment outcome (AOR 1.70 (95% CI: 1.19, 2.44). Additionally, being treated in government facilities, such as government hospitals and government primary health clinics, was a protective factor (AOR 0.06 (95% CI: 0.03, 0.15) and AOR 0.02 (95% CI: 0.01, 0.04), respectively.
Conclusion: The high proportion of unsuccessful treatment outcomes among relapse TB patients stresses the importance of adherence to routine sputum monitoring and public-private partnerships.
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