Factors associated with successful treatment outcomes in Pulmonary tuberculosis among older people in Bangkok

Abstract

The incidence and mortality rates of pulmonary tuberculosis (TB) have been steadily increasing among the older population. This study aimed to identify factors associated with treatment success in older people with pulmonary TB in the Bangkok metropolitan area. A nested case-control study design was employed, with a 1:1 ratio, using retrospective data from the National Tuberculosis Information Program (NTIP) database. The study population consisted of 245 successfully treated patients (cases) and 245 treatment failure patients (controls). Conditional logistic regression analysis was conducted to determine factors associated with treatment success. The results showed that two factors were significantly associated with treatment success in older people with pulmonary TB in Bangkok. The absence of comorbidities, specifically diabetes mellitus, was found to be significantly associated with treatment success (Adjusted Odds Ratio [AOR]: 11.36, 95% Confidence Interval [CI]: 4.64- 27.80). Additionally, patients with negative acid-fast bacilli (AFB) smear results during the second month of treatment had a higher likelihood of treatment success (AOR: 13.73, 95% CI: 4.02-46.94). Based on these findings, it is recommended to implement policies and strategies for screening and closely monitoring older people with pulmonary TB, particularly those with comorbidities such as diabetes mellitus, and patients with positive AFB smear results during the intensive phase of treatment. This approach aims to enhance access to effective treatment and ensure close follow-up, ultimately improving treatment success rates for pulmonary TB in the older population.