Risk Factors of Treatment Failure among Pulmonary Tuberculosis Patients: Systematic Review

Abstract

Introduction: Tuberculosis (TB) treatnent failure has become one of the factors of TB massive spread and has led to an increase in Drug-Resistant TB (DR-TB). Indonesia has not achieve the target of successful TB treatment in 2021. Objective: The aim of this systematic review to determine the factors associated with TB treatment faulure in various countries so that the result should be used as a reference in soling the TB problem in Indonesia. Method: There are four databases (PubMed, Scopus, EMBASE and MEDLINE) used to search for articles. Keywords used for searching include: (tuberculosis) OR (TB) AND (treatment failure) OR (treatment default) OR (treatment flop). Searching for articles in this systematic review refers to the PRISMA (Preferred Reporting Items for Systematic Reviews and MetaAnalysis) diagram. Result: Analysis was carried out on six articles originating from different countries, namely Burkina Faso, Pakistan, Ethiopia, China, Colombia and Malaysia. Only one article used a case-control design while the rest were retrospective cohort studies. The characteristics of the sample are that the majority are men and are in the productive age range. In this study, factors were found that were associated with TB treatment failure, including age, male gender, education, recurrent TB cases, TB-HIV, diabetes mellitus, smoking, as well as other factors, such as living in urban areas, decreased Body weight, time to start treatment, bacilli load, severity of disease, treatment management, supervision of medication taking, use of drugs (drugs), and location of extra-pulmonary TB are also included in the risk factors for TB treatment failure. Conclusion: Efforts are needed to overcome risk factors to reduce TB treatment failure, such as assistance with treatment, especially for elderly patients, collaboration with smoking cessation services in standard TB case management practices, and preventing TB-HIV co-infection by screening vulnerable groups.