The trend of tuberculosis case notification and predictors of unsuccessful treatment outcomes in Samdrup Jongkhar district, Bhutan: A fourteen-year retrospective study
Open accessAbstract
Tuberculosis (TB) continues to be an important public health issue in Bhutan. This study aims to describe the trend of tuberculosis and investigate factors associated with a unsuccessful treatment outcome in Samdrup Jongkhar District in Bhutan. A fourteen-year (2004-2017) case records in two TB centres of Dewathang and Samdrup Jongkhar Hospitals were reviewed and analyzed to examine trends in case notification and treatment outcomes. Univariable and multivariable logistic regression analysis was undertaken to identify covariates of unsuccessful TB treatment. Of the total of 820 TB cases registered in surveillance record, 729 cases were analysed. Males made up 53.8% (397) of total cases and the median age was 29 years (range: 2-87 years). A gradual downward trend in TB case notification was noticed in the district with overall case notification rate of 139/100,000 during the study period. The annual treatment success rate was over 90% except for years 2013-2015 with overall treatment success rate for the study period at 93%. A re-treatment TB patient, sputum-positive at the second month of treatment and being of Indian nationality were significant correlates of unsuccessful treatment outcomes. The overall TB inclidence has declined and TB treatment success rate was above WHO recommended 90% in Samdrup Jongkhar District during the study period. A special attention should be paid to the poor treatment outcome predictors including re-treatment cases and failed sputum conversion at the second month of treatment.
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The percentage of TB-related deaths in this study (1.6%) was lower than national (4%) and other studies in India, Bhutan, and Ethiopia.
“However, the percentage of TB-related deaths in this study (1.6%) was lower than in national (4%) and other studies in India, Bhutan, and Ethiopia19,20.”
From Prevalence of extrapulmonary tuberculosis and factors influencing successful treatment outcomes among notified cases in South India (2025) · cites this paper as [19]
The Results table records 14 deaths (1.9%) in this Bhutan study, so its rate is higher than the citing study’s 1.6%. The Discussion says the 1.9% rate was lower than rates in other countries of Asia and Africa. Our copy does not give a national death rate of 4% or specifically establish the comparisons with India and Ethiopia. (LLM, conf=0.87)
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Cites
Global tuberculosis report (2014)
Gabbasova, L. A., & Who, E. R. E. (2014) · Cited by 12,702 · see citing works
Contrasting Computational Models of Mate Preference Integration Across 45 Countries
Conroy‐Beam, D., Buss, D. M., Asao, K., Sorokowska, A., Sorokowski, P., Aavik, T., Akello, G., Alhabahba, M. M., Alm, C., Amjad, N., et al. (2019) · Scientific Reports · doi:10.1038/s41598-019-52748-8 · Cited by 1,771 · see citing works
The global burden of tuberculosis: results from the Global Burden of Disease Study 2015
Kyu, H. H., Maddison, E. R., Henry, N. J., Mumford, J. E., Barber, R. M., Shields, C., Brown, J. C., Nguyen, G., Carter, A., Wolock, T. M., et al. (2017) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(17)30703-x · Cited by 375 · see citing works
New plan to end tuberculosis in south and southeast Asia
Sharma, D. C. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30817-6 · Cited by 290 · see citing works
Horne, D. J. D. L., Royce, S., Goozé, L., Narita, M., Hopewell, P. C., Nahid, P., & Steingart, K. R. (2010) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(10)70071-2 · Cited by 259 · see citing works
Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis
Torres, N. M. C., Rodríguez, J. J. Q., Andrade, P. S. P., Arriaga, M. B., & Netto, E. M. (2019) · PLoS ONE · doi:10.1371/journal.pone.0226507 · Cited by 171 · see citing works
Gebrezgabiher, G., Romha, G., Ejeta, E., Asebe, G., Zemene, E., & Ameni, G. (2016) · PLoS ONE · doi:10.1371/journal.pone.0150560 · Cited by 129 · see citing works
Singla, R., Osman, M. M., Khan, N. A., Al-Sharif, N., Al-Sayegh, M., & Shaikh, M. A. (2003) · PubMed · Cited by 91 · see citing works
Current status of treatment completion and fatality among tuberculosis patients in Spain.
Caylà, J. A., Caminero, J. A., Rey, R. D., Lara, N., Vallès, X., & Galdós-Tangüis, H. (2004) · PubMed · Cited by 85 · see citing works
Ditah, I. C., Reacher, M. H., Palmer, C., Watson, J. M., Innes, J., Kruijshaar, M. E., Luma, H. N., & Abubakar, I. (2007) · Thorax · doi:10.1136/thx.2006.073916 · Cited by 85 · see citing works
Kigozi, G., Heunis, C., Chikobvu, P., Botha, S., & van Rensburg, D. (2017) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2016.11.407 · Cited by 76 · see citing works
Stošić, M., Vuković, D., Babic, D. D., Antonijević, G., Foley, K. L., Vujcic, I. S., & Grujičić, S. Š. (2018) · BMC Public Health · doi:10.1186/s12889-018-6021-5 · Cited by 76 · see citing works
Tuberculosis in the WHO South-East Asia Region
Nair, N., Wares, F., & Sahu, S. (2010) · Bulletin of the World Health Organization · doi:10.2471/blt.09.073874 · Cited by 74 · see citing works
Choi, H., Lee, M., Chen, R. Y., Kim, Y., Yoon, S.-Y., Joh, J.-S., Park, S. K., Dodd, L. E., Lee, J., Song, T., et al. (2014) · BMC Infectious Diseases · doi:10.1186/1471-2334-14-360 · Cited by 69 · see citing works
Tola, A., Mishore, K. M., Ayele, Y., & Mekuria, A. N. (2019) · Tuberculosis Research and Treatment · doi:10.1155/2019/1503219 · Cited by 64 · see citing works
Endris, M., Moges, F., Belyhun, Y., Woldehana, E., Esmael, A., & Unakal, C. G. (2014) · Tuberculosis Research and Treatment · doi:10.1155/2014/726193 · Cited by 63 · see citing works
Wen, Y., Zhang, Z., Li, X., Xia, D., Ma, J., Dong, Y., & Zhang, X. (2018) · BMC Infectious Diseases · doi:10.1186/s12879-018-3019-7 · Cited by 63 · see citing works
Determinants of multidrug-resistant tuberculosis in Henan province in China: a case control study
Zhang, C., Wang, Y., Shi, G.-C., Han, W., Zhao, H., Zhang, H., & Xi, X. (2015) · BMC Public Health · doi:10.1186/s12889-016-2711-z · Cited by 61 · see citing works
Treatment outcomes of childhood tuberculosis in Addis Ababa: a five-year retrospective analysis
Tilahun, G., & Gebre-Selassie, S. (2016) · BMC Public Health · doi:10.1186/s12889-016-3193-8 · Cited by 61 · see citing works
Atif, M., Anwar, Z., Fatima, R., Malik, I., Asghar, S., & Scahill, S. L. (2018) · BMC Research Notes · doi:10.1186/s13104-018-3473-8 · Cited by 50 · see citing works
Exploring the determinants of treatment success for tuberculosis cases in Europe.
Falzon, D., Strat, Y. L., Belghiti, F. A. E., & Infuso, A. (2005) · PubMed · Cited by 45 · see citing works
Kebede, W., Abebe, G., & Bonsa, Z. (2019) · International Journal of Mycobacteriology · doi:10.4103/ijmy.ijmy_177_18 · Cited by 45 · see citing works
Predictors for Pulmonary Tuberculosis Treatment Outcome in Denmark 2009–2014
Holden, I. K., Lillebæk, T., Seersholm, N. J., Andersen, P. H., Wejse, C. M., & Johansen, I. S. (2019) · Scientific Reports · doi:10.1038/s41598-019-49439-9 · Cited by 42 · see citing works
Poor tuberculosis treatment outcomes in Southern Mozambique (2011–2012)
García‐Basteiro, A. L., Respeito, D., Augusto, O. J., López‐Varela, E., Sacoor, C. N., Sequera, G., Casellas, A., Bassat, Q., Manhiça, I., Macete, E., et al. (2016) · BMC Infectious Diseases · doi:10.1186/s12879-016-1534-y · Cited by 39 · see citing works
Ramarokoto, H., Randriamiharisoa, H., Rakotoarisaonina, A., Rasolovavalona, T., Rasolofo, V., Chanteau, S., Ralamboson, M., Cauchoix, B., & Rakotondramarina, D. B. (2002) · PubMed · Cited by 36 · see citing works
Rifat, M., Hall, J. J., Oldmeadow, C. J., Husain, A., Hinderaker, S. G., & Milton, A. H. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-008273 · Cited by 35 · see citing works
Childhood tuberculosis in Bhutan: profile and treatment outcomes
Dendup, T., Dorji, T., Edginton, M. E., Kumar, A. M. V., Wangchuk, D., Dophu, U., Jamtsho, T., & Rinzin, C. (2013) · Public Health Action · doi:10.5588/pha.12.0091 · Cited by 34 · see citing works
Tuberculosis treatment outcomes among disadvantaged patients in India
Jackson, C., Stagg, H. R., Doshi, A., Pan, D., Sinha, A. K., Batra, R., Batra, S., Abubakar, I., & Lipman, M. C. I. (2017) · Public Health Action · doi:10.5588/pha.16.0107 · Cited by 31 · see citing works
Mlotshwa, M., Abraham, N., Beery, M., Williams, S., Smit, S., Uys, M., Reddy, C., & Medina-Marino, A. (2016) · BMC Infectious Diseases · doi:10.1186/s12879-016-1712-y · Cited by 30 · see citing works
Babalık, A., Kılıçaslan, Z., Kızıltaş, Ş., Gençer, S., & Öngen, G. (2013) · Balkan Medical Journal · doi:10.5152/balkanmedj.2013.005 · Cited by 27 · see citing works
Choi, H., Lee, M., Chen, R. Y., Kim, Y., Yoon, S.-Y., Joh, J.-S., Park, S. K., Dodd, L. E., Lee, J., Song, T., et al. (2014) · Cited by 20 · see citing works
Sputum smear positivity at two months in previously untreated pulmonary tuberculosis patients
Singla, R., Bharty, S. K., Gupta, U. A., Khayyam, K. U., Vohra, V., Singla, N., Myneedu, V. P., & Behera, D. (2013) · International Journal of Mycobacteriology · doi:10.1016/j.ijmyco.2013.08.002 · Cited by 19 · see citing works
Ramakrishnan, J., Sarkar, S., Chinnakali, P., Lakshminarayanan, S., Sahu, S. K., Reshma, A., Knudsen, S., Das, M., Thekkur, P., Venugopal, V., et al. (2020) · Indian Journal of Tuberculosis · doi:10.1016/j.ijtb.2020.09.022 · Cited by 15 · see citing works
Second month sputum smear as a predictor of tuberculosis treatment outcomes in Brazil
Evangelista, M. D. S. N., Maia, R., Toledo, J., de Abreu, R. G., Ueleres, B. J., Barreira, D., & Trajman, A. (2018) · BMC Research Notes · doi:10.1186/s13104-018-3522-3 · Cited by 12 · see citing works
Treatment outcome of tuberculosis patient of Samtse General Hospital, Bhutan
Dorji, T., & Wangdi, K. (2020) · Nepal Journal of Epidemiology · doi:10.3126/nje.v10i3.28397 · Cited by 8 · see citing works
Self-citationKigozi, G., Chikobvu, P., Heunis, J. C., & van der Merwe, S. (2014) · Journal of Public Health in Africa · doi:10.4081/jphia.2014.324 · Cited by 6 · see citing works
Biehle, J. T. (2000) · American school & university · Cited by 3 · see citing works
Phuntsho, S. (2013) · NRCT Data Center · doi:10.14457/cu.the.2013.1049 · Cited by 1 · see citing works
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1 of the 39 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- [20]SEARO W. National Tuberculosis Control Programme Bhutan: Report of the External Review 2006
- [21]National Tuberculosis Control Program Progress Update and Annual Review Meeting 2016-2017 2016
Cited by
Sorted by citations
VidyaRaj, C. K., Vadakunnel, M. J., Mani, B. R., Anbazhagi, M., Pradhabane, G., Venkateswari, R., Palavesam, S., Venkatesh, K., Usharani, B., Sriramkumar, S. R., et al. (2025) · Scientific Reports · doi:10.1038/s41598-025-92613-5 · Cited by 31 · see citing works
Kumar, A., Harakuni, S. U., Paranjape, R., Korabu, A. S., & Prasad, J. B. (2024) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2024.101505 · Cited by 16 · see citing works
Kabiri, M., Anthony, A., Kofi, A. P., Sakyibea, D. H., Kortey, L., Owusu, F. K., & Ayenor, M. (2022) · Journal of Infectious Diseases and Epidemiology · doi:10.23937/2474-3658/1510264 · Cited by 3 · see citing works
Nima, G., Dorji, T., Dorji, C., & Zangpo, T. (2025) · Health Science Reports · doi:10.1002/hsr2.71241 · Cited by 1 · see citing works
Rai, N. B., Penjor, K., Gurung, A., Samdrup, T., Dargay, Y., Samzang, S., & Wangdi, K. (2025) · Asia Pacific Journal of Public Health · doi:10.1177/10105395251318112 · Cited by 1 · see citing works
Self-citationDorji, T., Tshering, K., Adhikari, L., Jamtsho, T., Bhujel, P., Lhaden, P., Sherry, N. L., Lin, C., Denholm, J. T., Wangchuk, S., et al. (2026) · Scientific Reports · doi:10.1038/s41598-026-38023-7 · Cited by 1 · see citing works
Aliyo, A., & Tuke, G. (2024) · Qeios · doi:10.32388/k3fiwn
Pradhan, N., Pradhan, U., Chandhanayingyong, C., & Chareancholvanich, K. (2026) · Journal of Medical Case Reports · doi:10.1186/s13256-025-05823-w · Cited by 1 · see citing works
- Authors
- Penjor, K., Kuenzang, Tshokey, T., & Wangdi, K.
- Affiliations
- Ministry of Health (BT)
- Australian National University (AU)
- Corresponding author
- Penjor, Kinley
- Venue
- Heliyon
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 7
- Issue
- 3
- Pages
- e06573
- ISSN
- 2405-8440 (ISSN-L)
- PMC
- PMC8027770
- OpenAlex
- W3140834024
- Cited by
- 9
- References
- 39
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2022: 2
- FWCI
- 0.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Heliyon (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Ministerio de Sanidad, Consumo y Bienestar Social
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
- Social Sciences › General Social Sciences › HIV, TB, and STIs Epidemiology
- Keywords
- tuberculosis, case notification trends, treatment outcome predictors, treatment success rate, retreatment tuberculosis, sputum conversion, Bhutan
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