BACKGROUND: @entity1 with @entity378 require retreatment if they fail or default from initial treatment or if they relapse following initial treatment success. Outcomes among @entity1 receiving a standard World Health Organization Category II retreatment regimen are suboptimal, resulting in increased risk of morbidity, drug resistance, and transmission.. In this study, we evaluated the risk factors for initial treatment failure, default, or early relapse leading to the need for @entity378 retreatment in Morocco. We also assessed retreatment outcomes and drug susceptibility testing use for retreatment @entity1 in urban centers in Morocco, where @entity378 incidence is stubbornly high. METHODS: @entity1 with smear- or culture-positive @entity1907 presenting for retreatment were identified using clinic registries in nine urban public clinics in Morocco. Demographic and outcomes data were collected from clinical charts and reference laboratories. To identify factors that had put these individuals at risk for failure, default, or early relapse in the first place, initial treatment records were also abstracted (if retreatment began within two years of initial treatment), and @entity1 characteristics were compared with controls who successfully completed initial treatment without early relapse. RESULTS: 291 @entity1 presenting for retreatment were included; 93% received a standard Category II regimen. Retreatment was successful in 74% of relapse @entity1 , 48% of failure @entity1 , and 41% of default @entity1 . 25% of retreatment @entity1 defaulted, higher than previous estimates. Retreatment failure was most common among @entity1 who had failed initial treatment (24%), and default from retreatment was most frequent among @entity1 with initial treatment default (57%). Drug susceptibility testing was performed in only 10% of retreatment @entity1 . Independent risk factors for failure, default, or early relapse after initial treatment included male gender (aOR = 2.29, 95% CI 1.10-4.77), positive sputum smear after 3 months of treatment (OR 7.14, 95% CI 4.04-13.2), and hospitalization (OR 2.09, 95% CI 1.01-4.34). Higher weight at treatment initiation was protective. Male sex, substance use, missed doses, and hospitalization appeared to be risk factors for default, but subgroup analyses were limited by small numbers. CONCLUSIONS: Outcomes of retreatment with a Category II regimen are suboptimal and vary by subgroup. Default among @entity1 receiving @entity378 retreatment is unacceptably high in urban areas in Morocco, and @entity1 who fail initial @entity378 treatment are at especially high risk of retreatment failure. Strategies to address risk factors for initial treatment default and to identify @entity1 at risk for failure (including expanded use of drug susceptibility testing) are important given suboptimal retreatment outcomes in these groups.

Risk factors for XXXX treatment failure, default, or relapse and outcomes of retreatment in Morocco.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity378 :: ('MESH:D014376', 'Disease') :: ['tuberculosis'] @entity1907 :: ('MESH:D014397', 'Disease') :: ['pulmonary tuberculosis']
@entity378 :: (MESH:D014376,Disease) :: ['tuberculosis']
