Evaluating tuberculosis treatment outcomes in Haiti from 2018 to 2019: A competing risk analysis

Objectives This study assesses TB treatment outcomes in Haiti. Methods Data from drug-susceptible TB patients (2018-2019) were analyzed using the Fine & Gray model with multiple imputation. Findings Among the 16,545 patients, 14∙7% had concurrent HIV coinfection, with a 66∙2% success rate. Median treatment duration was 5 months, with patients averaging 30 years (with an interquartile range of 22-42 years). The estimated hazard of achieving a successful treatment outcome decreased by 2∙5% and 8∙1% for patients aged 45 and 60, respectively, compared to 35-year-old patients. Male patients had a 6∙5% lower estimated hazard of success compared to their female counterparts. Additionally, patients coinfected with HIV experienced a 35∙3% reduction in the estimated hazard of achieving a successful treatment outcome compared to those with a negative HIV serologic status. Interpretation Integrated healthcare approaches should be implemented, incorporating innovative solutions such as machine learning algorithms combined with geographic information systems and non-conventional data sources (including social media) to identify tuberculosis hotspots and high burden households. Funding This study was co-funded by the Swiss National Science Foundation (PP00P3_202660) and the United States Agency for International Development (AID-521-A-17-00008).