Prevalence and factors associated with unsuccessful tuberculosis treatment outcome among adolescents and young adults in Rwanda, from 2019 to 2022

Abstract

Background: Despite good progress toward fighting and eliminating TB, the true burden of TB among adolescents and young adults (AYA) remains unclear. Attention has long been focused on TB cases among adults, and surveillance data have not been disaggregated to allow for estimates of TB among adolescents. Consequently, prevention and care policies typically overlook adolescents. Therefore, this study aimed to determine the prevalence and factors associated with unsuccessful TB treatment outcomes among AYA patients in Rwanda.

Methods: A cross-sectional study was conducted among AYA patients registered in the national electronic TB reporting system by all health facilities countrywide from July 2019 to June 2022. Patients aged from 10-24 years old with recorded treatment outcome were included in the study. Bivariate and multivariate logistic regression was computed to determine factors associated with unsuccessful TB treatment outcomes among AYA. Odds ratio (OR), 95% confidence interval (CI), and p-value

Results: This study included 1,550 AYA TB patients. Of them, 117 (7.5%) patients had unsuccessful treatment outcomes. In multivariate logistic regression analysis, clinically confirmed TB patients (OR= 1.5, 95% CI: 1.0-2.2), being HIV positive (AOR=3.6, 95% CI: 2.0- 6.3), and positive sputum smear after two months of TB intensive treatment (AOR=8.7, 95% CI: 5.1-14.8) were found to be significantly associated with unsuccessful TB treatment outcome among adolescents and young adults in Rwanda.

Conclusion: This study showed that unsuccessful TB treatment outcome among AYA patients was low compared to other studies conducted, efforts in close follow-up of TB-HIV coinfected AYA patients and carrying out a population-based study to explore additional factors/reasons behind TB treatment outcomes among AYA in Rwanda are the major recommendation from this study