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Meta-Analysis
. 2019 Dec 27;14(12):e0226507.
doi: 10.1371/journal.pone.0226507. eCollection 2019.

Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis

Ninfa Marlen Chaves Torres  1   2 , Jecxy Julieth Quijano Rodríguez  2 , Pablo Sebastián Porras Andrade  3 , María Belen Arriaga  4   5 , Eduardo Martins Netto  1   5
Affiliations
Meta-Analysis

Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis

Ninfa Marlen Chaves Torres et al. PLoS One. .

Abstract

Objective: To produce pooled estimates of the global results of tuberculosis (TB) treatment and analyze the predictive factors of successful TB treatment.

Methods: Studies published between 2014 and 2019 that reported the results of the treatment of pulmonary TB and the factors that influenced these results. The quality of the studies was evaluated according to the Newcastle-Ottawa quality assessment scale. A random effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (CI). This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) in February 2019 under number CRD42019121512.

Results: A total of 151 studies met the criteria for inclusion in this review. The success rate for the treatment of drug-sensitive TB in adults was 80.1% (95% CI: 78.4-81.7). America had the lowest treatment success rate, 75.9% (95% CI: 73.8-77.9), and Oceania had the highest, 83.9% (95% CI: 75.2-91.0). In children, the success rate was 84.8% (95% CI: 77.7-90.7); in patients coinfected with HIV, it was 71.0% (95% CI: 63.7-77.8), in patients with multidrug-resistant TB, it was 58.4% (95% CI: 51.4-64.6), in patients with and extensively drug-resistant TB it was 27.1% (12.7-44.5). Patients with negative sputum smears two months after treatment were almost three times more likely to be successfully treated (OR 2.7; 1.5-4.8), whereas patients younger than 65 years (OR 2.0; 1.7-2.4), nondrinkers (OR 2.0; 1.6-2.4) and HIV-negative patients (OR 1.9; 1.6-2.5 3) were two times more likely to be successfully treated.

Conclusion: The success of TB treatment at the global level was good, but was still below the defined threshold of 85%. Factors such as age, sex, alcohol consumption, smoking, lack of sputum conversion at two months of treatment and HIV affected the success of TB treatment.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow chart indicating the result of literature search.
Fig 2
Fig 2. Pooled estimate of successful tuberculosis treatment outcome.
Fig 3
Fig 3. Pooled estimate to negative smear in the 2nd month as a factors predictive of favorable outcomes of tuberculosis treatment.
Fig 4
Fig 4. Pooled estimate to age <65 years as a factors predictive of favorable outcomes of tuberculosis treatment.
Fig 5
Fig 5. Pooled estimate to Non-alcoholic as a factors predictive of favorable outcomes of tuberculosis treatment.
See this image and copyright information in PMC

References

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