Pneumology - Original Articles Open access

Determinants of unsuccessful treatment outcome of pulmonary tuberculosis under the National Tuberculosis Elimination Program in Mohali district, India

Authors

Published
17 September 2025
Section
Pneumology - Original Articles
DOI
10.4081/monaldi.2025.3363

Abstract

Tuberculosis is a global healthcare concern, being the leading infectious cause of mortality by a single infectious agent. India bears the highest burden of tuberculosis. Disease outcome is an important indicator for the successful implementation of the National Program. Risk factors associated with unsuccessful outcomes must be identified, and differential care must be provided to those with risk factors. The study included all pulmonary tuberculosis patients registered from 1st October 2022 to 30th September 2023 at the Directly Observed Therapy Short Course Center, Dr. BR Ambedkar State Institute of Medical Sciences, Mohali, who received treatment. Data were collected from the Nikshay portal retrospectively. Out of 1103, 575 (52.13%) patients were declared cured, whereas 452 (40.97%) were declared treatment completed. A total of 19 (1.72%) pulmonary tuberculosis patients died during treatment, and 57 (5.16%) were declared failures. Advanced age [adjusted odds ratio (AOR) 4.028, 95% confidence interval (CI): 1.368-4.610, p=0.003], people living with HIV (AOR 0.185, 95% CI: 0.031-1.082, p=0.05) and male gender (crude OR 1.611, 95% CI: 0.371-1.006, p=0.050) were associated with poor outcomes. Diabetes, retreatment, microbiological confirmation, and low body mass index were not statistically significant in the study. Age above 45 years, male sex, and HIV co-infection are determinants for unsuccessful treatment outcomes in patients with pulmonary tuberculosis.

Keywords

Ethics Approval

Approved by the Institutional Ethics Committee, Dr BR Ambedkar State Institute of Medical Sciences, Mohali, before starting the study (AIMS/IEC-HR/2024/63 dated 20.09.2024).

References

  1. World Health Organisation. WHO global TB report 2022. Available from: https://www.who.int/publications/i/item/9789240061729.
  2. Holmes KK, Bertozzi S, Bloom BR, et al. Major Infectious Diseases. 3rd ed. Washington (DC): The International Bank for Reconstruction and Development/The World Bank; 2017.
  3. World Health Organization. End TB strategy: global strategy and targets for tuberculosis prevention, care and control after 2015. Available from: https://cdn.who.int/media/docs/default-source/documents/tuberculosis/end-tb-strategy-information-sheet8817f818-feaa-49ac-b26a-92c5b9dca034.pdf.
  4. Limenh LW, Kasahun AE, Sendekie AK et al. Tuberculosis treatment outcomes and associated factors among tuberculosis patients treated at healthcare facilities of Motta Town, northwest Ethiopia: a five-year retrospective study. Sci Rep 2024;14:7695. DOI: https://doi.org/10.1038/s41598-024-58080-0
  5. Kumar A, Harakuni S, Paranjape R et al. Factors determining successful treatment outcome among notified tuberculosis patients in Belagavi district of North Karnataka, India. Clin Epidemiol Glob Health 2024;25:101505. DOI: https://doi.org/10.1016/j.cegh.2024.101505
  6. Amante TD, Ahemed TA. Risk factors for unsuccessful tuberculosis treatment outcome (failure, default and death) in public health institutions, eastern Ethiopia. Pan Afr Med J 2015;20:247. DOI: https://doi.org/10.11604/pamj.2015.20.247.3345
  7. Tafess K, Beyen TK, Abera A, et al. Treatment outcomes of tuberculosis at Asella teaching hospital, Ethiopia: ten years’ retrospective aggregated data. Front Med 2018;5:38. DOI: https://doi.org/10.3389/fmed.2018.00038
  8. Berhan A, Almaw A, Solomon Y. Tuberculosis treatment outcome and associated factors among tuberculosis patients linked to tuberculosis treatment clinics in Ethiopia, 2023: a multi-center retrospective study. Infect Drug Resist 2023;16:3367-78. DOI: https://doi.org/10.2147/IDR.S413272
  9. Araia ZZ, Kibreab F, Kibrom AA et al. Determinants of unsuccessful tuberculosis treatment outcome in Northern Red Sea region, Eritrea. PLoS One 2022;17:e02773069. DOI: https://doi.org/10.1371/journal.pone.0273069
  10. Ridolfi F, Peetluk L, Amorim G, et al. Regional prospective observational research in tuberculosis (RePORT)–Brazil consortium. Tuberculosis treatment outcomes in Brazil: different predictors for each type of unsuccessful outcome. Clin Infect Dis 2023;76:e930- 7. DOI: https://doi.org/10.1093/cid/ciac541
  11. Gadoev J, Asadov D, Harries AD, et al. Factors associated with unfavourable treatment outcomes in patients with tuberculosis: a 16-year cohort study (2005–2020), Republic of Karakalpakstan, Uzbekistan. Int J Environ Res Public Health 2021;18:12827. DOI: https://doi.org/10.3390/ijerph182312827
  12. Chilyabanyama R, Kamanga N ,Mwandia JN. Factors associated with tuberculosis treatment outcomes among TB patients aged 15 years and older at chawama level one hospital in Lusaka, Zambia, Glob Public Health 2024;19:2307979. DOI: https://doi.org/10.1080/17441692.2024.2307979
  13. Wen Y, Zhang Z, Li X, et al. Treatment outcomes and factors affecting unsuccessful outcome among new pulmonary smear positive and negative tuberculosis patients in Anqing, China: a retrospective study. BMC Infect Dis 2018;18:104. DOI: https://doi.org/10.1186/s12879-018-3019-7
  14. Gilmour B, Xu Z, Bai L, et al. Risk factors associated with unsuccessful tuberculosis treatment outcomes in Hunan Province, China. Trop Med Int Health 2022;27:290-9. DOI: https://doi.org/10.1111/tmi.13720
  15. Population census. Mohali (Sahibzada Ajit Singh Nagar) District - Population 2011-2025. Available from: https://www.census2011.co.in/census/district/605-mohali.html.
  16. Central Tuberculosis Division. India TB report 2022. Available from: https://tbcindia.mohfw.gov.in/2023/06/06/india-tb-report-2022/.
  17. Central Tuberculosis Division. Technical and operational guidelines (TOG) for TB control in India 2016 – chapter 4: treatment of TB. Available from: https://tbcindia.mohfw.gov.in/technical-and-operational-guidelines-for-tb-control-in- india-2016/.
  18. World Health Organization. Definitions and reporting framework for tuberculosis – 2013 revision: updated December 2014 and January 2020. Available from: https://www.who.int/publications/i/item/9789241505345.
  19. Tola A, Minshore KM, Ayele Y, Mekuria AN. Tuberculosis treatment outcomes and associated factors among TB patients attending public hospitals in Harar town, Eastern Ethiopia: a five-year retrospective study. Tuberc Res Treat 2019;2019:1503219. DOI: https://doi.org/10.1155/2019/1503219
  20. Loscalzo J, Fauci A, Kasper D. Harrison's principles of internal medicine, 21st ed. New York, NY, USA: McGraw-Hill Education; 2022.
  21. Ifebunandu NA, Ukwaja KN, Obi SN. Treatment outcome of HIV-associated tuberculosis in a resource-poor setting. Trop Doct 2012;42:74-6. DOI: https://doi.org/10.1258/td.2011.110421
  22. Sharma SK, Soneja M, Prasad KT, Ranjan S. Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India. Indian J Med Res 2014;139:154-60.
  23. Baltas I, Sturdy A, Kavallieros K et al. Diabetes mellitus is not a predictor of poor TB treatment outcomes. Int J Tuberc Lung Dis 2023;27:140-5. DOI: https://doi.org/10.5588/ijtld.22.0470
  24. Alkabab Y, Warkentin J, Cummins J et al. Therapeutic drug monitoring and TB treatment outcomes in patients with diabetes mellitus. Int J Tuberc Lung Dis 2023;27:135-9. DOI: https://doi.org/10.5588/ijtld.22.0448

Metrics

Citations and online attention from Dimensions, Altmetric and PlumX.

PlumX Metrics

License

Copyright (c) 2025 The Author(s)

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.