OBJECTIVES: Monitoring of tuberculosis (TB) treatment determines the causes of therapy failure. It is a critical indicators for assessing the National tuberculosis control program's (NTP) performance. This study was aimed to identify the predictors and factors associated with ineffective treatment outcomes of pulmonary tuberculosis (PTB).

METHODS: A retrospective study was conducted in the District Headquarter (DHQ), Teaching Hospital Bannu, Khyber Pakhtunkhwa (KPK), Pakistan from 2014 to 2018. Total of 1,426 PTB patients including male (65.7%) and female (34.3%) aged 12-90 years were included. The demographics, along with smoking habits and co-morbidities were recorded with the patient's consent. Data was analyzed using SPSS 23.0. The univariate and multivariate logistic regression was applied.

RESULTS: The success ratio of the treatment was observed to be 86.47% among PTB patients. While some patients (13.5%) were failed to comply therapy. Smoking (p=0.03, OR= 2.176; 95% CI 1.07-4.404) and cough (p < .0005, OR=0.457, 95% CI 0.315-0,715) were associated factors of therapeutic failure. Some co-morbid patients (p=< .0005, OR= 0.567, 95% CI 0.372-0.86) with diabetes (10.2%), hypertension (3.5%), Chronic obstructive pulmonary disease (COPD) (2.2%) showed unsuccessful treatment outcomes. This study also predicted that married patients (p=< .0005, OR= 0.481; 95% CI 0.346-0.668), had a low success rate. The patients with sputum-positive smear (p=0.006, OR=2.216; 95% CL 1.263-3.889), also demonstrate the unsuccessful treatment outcomes.

CONCLUSIONS: This study reveals that the ratio of unsuccessful treatment outcomes is still high. Pakistan can't meet the “End TB Strategy” by WHO. Co-morbid patients need some additional care. A planned smoking cessation program may help to improve therapeutic outcomes. Family care may help married patients. Finally, a scheduled follow-up scheme should be designed according to each patient.