Factors Influencing Tuberculosis Treatment Outcomes in Lalitpur District, Nepal: A Retrospective Cohort Study.

Abstract

Purpose: Tuberculosis (TB) remains a major public health challenge in low- and middle-income countries, including Nepal. Understanding the factors associated with TB treatment outcomes is essential for improving disease control and patient management.

Methods: A retrospective study was conducted using TB program data from Lalitpur District, Nepal. De-identified patient records were extracted from the Health Information Management System and the national e-TB register. Sociodemographic, behavioral, and clinical variables were analyzed. Descriptive statistics summarized patient characteristics, while Pearson's chi-square test assessed associations between variables and treatment outcomes. Multivariable logistic regression was used to identify predictors of treatment success.

Results: A total of 2,779 TB patients were included in the study. The overall treatment success rate was high, with most patients completing treatment successfully. Age, gender, and HIV status were significantly associated with treatment outcomes. Patients older than 60 years had higher odds of unsuccessful treatment compared with younger patients. Female patients showed higher odds of treatment success than males. HIV-positive patients had significantly poorer treatment outcomes compared with HIV-negative individuals. Other factors, including ethnicity, residence, smoking status, TB type, registration type, treatment category, DOTS delivery approach, and GeneXpert results, were not significantly associated with treatment success.

Conclusion: Age, gender, and HIV status were key predictors of TB treatment outcomes in Lalitpur District. Strengthening integrated TB-HIV care, improving follow-up among older patients, and enhancing treatment adherence among male patients may help improve treatment success rates. These findings provide evidence to support targeted TB control strategies and contribute to achieving the World Health Organization's End TB Strategy goals.