Risk Factors for Treatment Failure of Drug-Susceptible Pulmonary Tuberculosis in Lithuania over 22 Years

Background and Objectives: This study aimed to evaluate the treatment outcomes of adults with pulmonary drug-susceptible tuberculosis (DS-TB) in Lithuania over 22 years, and to examine associations between treatment outcomes, various risk factors, and temporal trends. Materials and Methods: A retros...

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Published in:Medicina (Kaunas, Lithuania) Vol. 61; no. 10; p. 1805
Main Authors: Kėvelaitienė, Karolina, Puronaitė, Roma, Davidavičienė, Valerija Edita, Nakčerienė, Birutė, Danila, Edvardas
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 08.10.2025
Subjects:
Acquired immune deficiency syndrome
Adult
Aged
AIDS
Antitubercular agents
Antitubercular Agents - therapeutic use
Care and treatment
Clinical outcomes
Cohort Studies
Comorbidity
Diabetes
Drug resistance
Drug resistance in microorganisms
Drug therapy
drug-susceptible tuberculosis management
drug-susceptible tuberculosis treatment outcome
Failure
Female
Health aspects
HIV (Viruses)
Homelessness
Humans
Laboratories
Lithuania
Lithuania - epidemiology
Lung diseases
Male
Microscopy
Middle Aged
Mortality
Patients
Public health
Respiratory agents
Retrospective Studies
Risk Factors
Sociodemographics
Substance abuse
Success
Switzerland
Treatment Failure
Tuberculosis
tuberculosis risk factors
Tuberculosis, Pulmonary - drug therapy
Tuberculosis, Pulmonary - epidemiology
Tuberculosis, Pulmonary - mortality
Lithuania
Switzerland
drug-susceptible tuberculosis management
drug-susceptible tuberculosis treatment outcome
tuberculosis risk factors
ISSN:1648-9144, 1010-660X, 1648-9144
Online Access:Get full text
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Summary:Background and Objectives: This study aimed to evaluate the treatment outcomes of adults with pulmonary drug-susceptible tuberculosis (DS-TB) in Lithuania over 22 years, and to examine associations between treatment outcomes, various risk factors, and temporal trends. Materials and Methods: A retrospective cohort analysis was conducted using data from the National Tuberculosis Information System from 2000 to 2021. A total of 18,697 adult patients with DS-TB were included. Patients were grouped into three time periods: Period I (2000–2007), Period II (2008–2015), and Period III (2016–2021). Treatment outcomes were categorized as successful (treatment completed with recovery) or unsuccessful (patients who encountered treatment failure, died during treatment, or converted to drug-resistant tuberculosis). Associations with individual risk factors, including smoking, alcohol use, comorbidities, and sociodemographic variables, were analyzed. Results: Treatment success rates improved steadily across the study periods: 82.3% in Period I, 84.4% in Period II, and 87.6% in Period III. Mortality rates declined over time but remained substantial: 17.1%, 15.2%, and 12.0% in Periods I, II, and III, respectively. Non-lethal treatment failures decreased slightly (0.6%, 0.4%, and 0.4%). Multivariate analysis identified significant associations between treatment failure and multiple risk factors, including low BMI, male gender, unemployment, homelessness, smoking, alcohol and substance use, and comorbid conditions such as cancer, cardiovascular disease, chronic lung disease, diabetes mellitus, HIV, and renal failure. Conclusions: Treatment outcomes for DS-TB in Lithuania have improved over the past two decades; however, certain modifiable risk factors—such as low BMI, homelessness, substance use, and comorbidities—remain strongly linked to treatment failure. To further improve outcomes, targeted interventions such as nutritional support, housing programs, and integrated addiction services should be prioritized for high-risk groups within national TB control efforts.
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ISSN:1648-9144
1010-660X
1648-9144
DOI:10.3390/medicina61101805