Analysis of the multi-drug resistant tuberculosis treatment outcomes: Experience from the special hospital for pulmonary diseases "Ozren" - Sokobanja

Abstract

Multidrug-resistant tuberculosis (MDR TB) is currently considered to be the most significant and dangerous obstacle to the TB elimination, and the work on preventing this form of disease is considered as a major contribution to human health and resource management. The purpose of the article is to analyse treatment outcomes in patients treated for multiresistant tuberculosis at the Special Hospital for Pulmonary Diseases "Ozren" - Sokobanja in the period from 2009 to 2019 and identify factors associated with treatment outcomes. We performed a retrospective analysis of the treatment outcomes in all (n=89) cases of MDR TB treated over the period from 2009-2019 at the Special Hospital for Pulmonary Diseases Ozren - Sokobanja. Descriptive statistical analysis of all available MDR TB characteristics was used. Logistic regression analysis was used to identify factors associated with successful treatment (treatment outcomes "cured" and "treatment completed") and mortality. Patient mortality was statistically significantly associated with undernutrition (OR = 5.55; 95% CI: 1.39-20.00), alcohol consumption (OR = 4.54; 95% CI: 1.22-10.67), bilateral cavitary lesions (OR = 16.67; 95% CI: 3.03-100.00), multiple prior treatment episodes (p<0.001), longer time to diagnosis (p<0.001), higher average number of hospitalizations and previous treatment episodes (p<0.001), and the following comorbidities: pulmonary (OR = 14.29; 95% CI: 2.70-100.00), cardiovascular diseases (OR = 7.14; 95% CI: 1.79-25.00), diabetes (OR = 5.88; 95% CI: 1.39-25.00) and malignant diseases (OR = 12.50; 95% CI: 1.85-100.00). The success of MDR TB treatment is very good. To maintain and further improve this success, it is necessary to focus interventions on resolving social issues and comorbidities among patients from risk groups associated with poor treatment outcomes, as well as on education of health professionals related to suspicion of TB, its recognition and referral to specialized institutions for MDR TB diagnostics and treatment.