Factors influencing the length of hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: A retrospective follow up study

Abstract

Background: The length of hospital stay is the duration of hospitalization and reflects disease severity and resource utilization indirectly. Generally, tuberculosis considered as an ambulatory disease able to be treated at DOTs clinics, however, hospitalization remains an important component for clinical stabilization of patients. Hence, this study aimed to identify factors influencing the length of hospital stay during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia.Methods: An institution-based retrospective follow-up study was conducted at three hospitals, namely the University of Gondar comprehensive specialized, Borumeda, and Debremarkos referral from September 2010 to December 2016 (n=432). Data were extracted from hospital admission/discharge logbooks and individual patient medical charts. Logistic regression analysis was used to identify factors associated with longer hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment.Result: Most patients (93.5%) had a pulmonary form of multidrug-resistant tuberculosis and 26.2% had /TB/HIV co-infections. The median length of hospital stay was 62 (interquartile range 36 to 100) days. The pulmonary form of tuberculosis (Adjusted odds ratio [AOR], 3.47, 95% confidence interval [CI]; 1.31 to 9.16), functional status of bedridden (AOR= 2.88, 95%CI; 1.29 to 6.43), and reported adverse drug effects (AOR=2.11, 95%CI; 1.35 to 3.30) were significant predictors of extended hospital stays.Conclusion: The study revealed that the length of hospital-stay differed significantly between the hospitals. The pulmonary form of tuberculosis decreased functional status at admission and reported adverse drug reactions were determinants of longer hospital stays. This underscores the importance of early case detection and prompt treatment of adverse drug effects.