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Int J Mycobacteriol. 2019 Oct-Dec;8(4):359-365. doi: 10.4103/ijmy.ijmy_142_19.

Determinants of treatment failure among tuberculosis patients in Kandahar City, Afghanistan: A 5-year retrospective cohort study.

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Department of Paediatrics, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan.
Department of Histopathology, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan.
Department of Clinical Trials Support Group, Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Department of Surgery, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan.
Department of Internal Medicine, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan.



Tuberculosis (TB) is a preventable and treatable chronic disease. Afghanistan is among the high-TB-burden countries. The aim of this study is to find the determinants of treatment failure among TB patients in Kandahar City, Afghanistan.


This was a retrospective cohort study conducted in Kandahar City during a period of 5 years (August 2014-July 2019). For data analysis; descriptive statistics, Chi-square test, and logistic regression were used.


Among 1416 TB patients, 894/1416 (63.1%) had pulmonary TB (PTB), whereas 522/1416 (36.9%) had extrapulmonary TB (EPTB). Mean age in these patients was 34.7 years while most of them were females in PTB (530/894 [59.3%]) and EPTB (340/522 [65.1%]) patients. Sputum smear was positive in 618/860 (71.9%) and 16/404 (4%) of PTB and EPTB patients, respectively. TB treatment failure was more in PTB (56/894 [6.3%]) than EPTB (4/522 [0.8%]). Chi-square test of TB cases showed that statistically significant determinants that may cause the treatment failure were re-treatment cases (crude odds ratio [COR] 7.7, P < 0.001), absence of fever (COR 5.2, P < 0.001), absence of cough (COR 1.7, P = 0.004), living in rural areas (COR 1.4, P = 0.035), and no weight loss (COR 1.3, P = 0.033). Binary logistic regression of the statistically significant variables revealed only absence of fever (adjusted odds ratio 6.0, P < 0.001) as the risk factor for treatment failure in TB patients.


TB is still a major threat for Kandahar City. Low treatment success rate and increased number of defaulted cases are the major threats.


Determinants; extrapulmonary; factors; pulmonary; tuberculosis

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