Real-World Outcomes of Ambulatory Drug-Susceptible Tuberculosis Management During the COVID-19 Pandemic in Romania.

@article{munteanu2026realworld,
  title = {{Real-World Outcomes of Ambulatory Drug-Susceptible Tuberculosis Management During the COVID-19 Pandemic in Romania.}},
  author = {Ioana Munteanu and Alexandru Stoichiță and Silviu Gabriel Vlasceanu and Mara Balteanu and Oana Andreea Parlițeanu and Traian Constantin Panciu and Adriana Mihaela Iliesiu and Dragos Baiceanu and Ioana-Mădălina Moşteanu and Alexandru-Neculai Pavel and Beatrice Mahler},
  journal = {Diseases (Basel, Switzerland)},
  year = {2026},
  month = oct,
  doi = {10.3390/diseases14100370},
  url = {https://europepmc.org/article/MED/42929997},
  note = {CC BY},
}

TY  - JOUR
TI  - Real-World Outcomes of Ambulatory Drug-Susceptible Tuberculosis Management During the COVID-19 Pandemic in Romania.
AU  - Ioana Munteanu
AU  - Alexandru Stoichiță
AU  - Silviu Gabriel Vlasceanu
AU  - Mara Balteanu
AU  - Oana Andreea Parlițeanu
AU  - Traian Constantin Panciu
AU  - Adriana Mihaela Iliesiu
AU  - Dragos Baiceanu
AU  - Ioana-Mădălina Moşteanu
AU  - Alexandru-Neculai Pavel
AU  - Beatrice Mahler
PY  - 2026
DA  - 2026/10/06
JO  - Diseases (Basel, Switzerland)
DO  - 10.3390/diseases14100370
UR  - https://europepmc.org/article/MED/42929997
AB  - Background  Romania continues to experience one of the highest tuberculosis (TB) burdens in the European Union/European Economic Area. During the COVID-19 pandemic, reduced inpatient capacity accelerated the use of ambulatory care for patients with drug-susceptible tuberculosis (DS-TB). This study evaluated treatment outcomes, outcome ascertainment, hospitalization requirements, and factors associated with unfavorable outcomes among patients managed through ambulatory TB services.Methods  We conducted a retrospective observational cohort study of adults with pulmonary or extrapulmonary DS-TB managed through ambulatory tuberculosis dispensaries affiliated with the "Marius Nasta" Institute of Pneumophthisiology, Bucharest, Romania, between January 2020 and December 2022. Treatment outcomes were defined according to World Health Organization criteria. Factors associated with unfavorable outcome were assessed using Firth penalized-likelihood logistic regression. Hospitalization during treatment was analyzed as a secondary outcome.Results  The final cohort comprised 545 patients with DS-TB, with a mean age of 44.8 years and 56.1% being male. Overall, 281 of 545 patients achieved treatment success, corresponding to a WHO-defined treatment-success rate of 51.6%. Twenty-seven patients (5.0%) experienced an unfavorable outcome, while 237 (43.5%) were classified as not evaluated. Among the 308 patients for whom a determinate end-of-treatment outcome was available, 281 (91.2%) achieved treatment success; however, this conditional proportion does not represent the programmatic treatment-success rate for the entire cohort.Conclusions  Structured ambulatory DS-TB care was operationally feasible within this tertiary-care-linked dispensary network during the COVID-19 pandemic. However, the WHO-defined treatment-success rate for the entire cohort was 51.6%, largely reflecting the substantial proportion of patients without an evaluable final outcome. The high proportion of not-evaluated patients represents an important programmatic weakness and limits conclusions regarding the effectiveness of the ambulatory model. Improved outcome ascertainment and continuity of follow-up are essential components of decentralized TB care.
SN  - 2079-9721
ER  -