Intensive Phase Treatment Outcome and Associated Factors among Patients Treated for Multi Drug Resistant Tuberculosis in Ethiopia: A retrospective cohort study

Molie, Teklu; Teklemariam, Zelalem; Klinkenberg, Eveline; Dessie, Yadeta; Kumsa, Andargachew; Mohammed, Hussen; Debebe, Adisalem; Assefa, Dawit; Habte, Abebe; Bedru, Ahmed; Fiseha, Daniel; Seyoum, Berhanu

doi:10.21203/rs.2.9211/v2

Cited by 4 publications

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“…Then, 347 articles were screened by title and abstract. The full-text screening was conducted for 58 articles, and 17 articles that fulfilled the eligibility criteria were included in the final analysis (Ketema et al, 2019;Molie et al, 2019;Alene et al, 2017;Limenih and Workie, 2019;Woldeyohannes et al, 2019;Tola et al, 2019;Meressa et al, 2015;Getachew et al, 2013;Girum et al, 2017;Shimbre et al, 2020;Gebre et al, 2020;Fantaw et al, 2018;Molalign and Wencheko, 2015;Woya et al, 2019;Abebe et al, 2020;Baye et al, 2018;Tulu and Kahissay, 2014) (Table 1 and Figure 1). All of the studies were hospital-based retrospective cohort studies conducted among patients with DR-TB treated under TICs found in different parts of the country.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Additionally, the clinical profiles (comorbidity types, clinical complication types, anatomical site of infection, diagnostic methods, drug resistance profiles, HIV serostatus, treatment outcomes and definition of anemia) of DR-TB patients per individual study were assessed and we summarized this in detail in Table 2. Among all 17 studies, 12 (Alene et al, 2017;Woldeyohannes et al, 2019;Meressa et al, 2015;Getachew et al, 2013;Girum et al, 2017;Shimbre et al, 2020;Gebre et al, 2020;Fantaw et al, 2018;Molalign and Wencheko, 2015;Woya et al, 2019;Abebe et al, 2020;Baye et al, 2018) and 15 (Ketema et al, 2019;Molie et al, 2019;Alene et al, 2017;Limenih and Workie, 2019;Woldeyohannes et al, 2019;Meressa et al, 2015;Getachew et al, 2013;Girum et al, 2017;Shimbre et al, 2020;Gebre et al, 2020;Fantaw et al, 2018;Molalign and Wencheko, 2015;Woya et al, 2019;Abebe et al, 2020;Baye et al, 2018) studies explored mortality and poor treatment outcomes, respectively. The incidence density rate of poor treatment outcome and mortality using the time to an event (poor treatment outcome or mortality) were explored by 12 (Ketema et al, 2019;Alene et al, 2017;Limenih and Workie, 2019;Woldeyohannes et al, 2019;Getachew et al, 2013;Girum et al, 2017;Shimbre et al, 2020;Gebre et al, 2020;Fantaw et al, 2018;<...>…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Among all studies, 15 (Ketema et al, 2019;Molie et al, 2019;Alene et al, 2017;Limenih and Workie, 2019;Woldeyohannes et al, 2019;Meressa et al, 2015;Getachew et al, 2013;Girum et al, 2017;Shimbre et al, 2020;Gebre et al, 2020;Fantaw et al, 2018;Molalign and Wencheko, 2015;Woya et al, 2019;Abebe et al, 2020;Baye et al, 2018) and 12 (Ketema et al, 2019;Alene et al, 2017;Limenih and Workie, 2019;Woldeyohannes et al, 2019;Getachew et al, 2013;Girum et al, 2017;Shimbre et al, 2020;Gebre et al, 2020;Fantaw et al, 2018;Molalign and Wencheko, 2015;Woya et al, 2019;Abebe et al, 2020) studies reported proportion and incidence rate of poor treatment outcome among patients treated for MDR/RR-TB under TICs in Ethiopia respectively. The largest sample size (n = 751) was from 14 TICs found in Ethiopia by Molie et al (2019), while the smallest sample size was from Boru Meda hospital in a study done by Baye et al (2018) (n = 90). The lowest proportion of poor treatment outcomes among patients treated for drug-resistant tuberculosis was reported by Shimbre et al (2020), which was 8.23%.…”

Section: The Pooled Incidence Of Poor Treatment Outcomementioning

confidence: 99%

“…Failure in treatment lengthens treatment period, since people continue to receive the treatment and inappropriate Abbreviations: BMI, body mass index; DR-TB, drug-resistant tuberculosis; EPTB, extrapulmonary tuberculosis; HIV, human immunodeficiency virus; MDR-TB, multi drug-resistant tuberculosis; PM, person months; PTB, pulmonary tuberculosis; RR-TB, rifampicin resistant tuberculosis; TIC, treatment initiative centers; TB, Tuberculosis; XDR-TB, extensively drug-resistant tuberculosis. management can have life-threatening results (Molie et al, 2019;Nair et al, 2017). In 2018, there were about 214,000 deaths from MDR/rifampicin resistant TB (RR-TB) (WHO, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Poor treatment outcome and its predictors among drug-resistant tuberculosis patients in Ethiopia: A systematic review and meta-analysis

Alemu

Bitew

Worku

2020

International Journal of Infectious Diseases

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To assess poor treatment outcomes and their predictors among drug-resistant tuberculosis patients treated in Ethiopia. Methods: Data were searched from both electronic databases and other sources. From the whole search, 404 articles were reviewed and 17 articles that fulfilled the inclusion criteria were included in the analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed and Joanna Briggs Institute Critical Appraisal checklist was used for assessing the quality. Risk of bias was assessed using forest plot and Egger's regression test. Data were analyzed using STATA version 15 and Review Manager Software version 5.3. Results: The overall pooled proportion of poor treatment outcome and mortality was 17.86% and 15.13% respectively. The incidence density rate of poor treatment outcome and mortality was 10.41/1000 person-months and 9.28/1000 person-months respectively. Survival status and successful treatment outcomes were 76.97% and 63.82% respectively. HIV positivity, non-HIV comorbidities, clinical complications, extrapulmonary involvement, undernutrition, anemia, treatment delay, lower body weight, and older age were the predictors of poor treatment outcome. Conclusion:Better survival and treatment success rates were noted in Ethiopia as compared to the global average. The majority of the poor treatment outcomes occurred within the intensive phase. Early initiation of anti-tuberculosis treatment would be important for successful treatment outcomes.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: The Pooled Incidence Of Poor Treatment Outcomementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Poor treatment outcome and its predictors among drug-resistant tuberculosis patients in Ethiopia: A systematic review and meta-analysis

Alemu

Bitew

Worku

2020

International Journal of Infectious Diseases

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“…Thus, all patients in the same group received the same regimen as per national guidance and widely approached in Ethiopia [8,9]. The intensive phase of drug-resistant TB, the rst 8-12 months, is the period in which patients suffer from critical disease conditions and drug side effects [10,11]. Moreover, has life-threatening adverse drug effects of second-line anti-TB medications led to more frequent and prolonged hospitalizations during this phase of the treatment [12,13].…”

Section: Introductionmentioning

confidence: 99%

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

Tamirat

Andargie

Babel

2020

Preprint

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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.

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Survival Status and Predictors of Mortality among Multidrug-Resistant Tuberculosis Patients in Saint Peter’s Specialized Hospital, Addis Ababa, Ethiopia

Muluneh

Zeru

Derseh

et al. 2021

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Multidrug-Resistant Tuberculosis (MDR-TB) is tuberculosis that is resistant to at least both rifampicin and isoniazid. The World Health Organization as reported in 2019 revealed that Ethiopia is among the 20 countries with the highest estimated numbers of incident MDR-TB cases. However, supporting evidence is limited in the study area after the Ethiopian national strategic plan for tuberculosis prevention and control is started. Objective. To determine survival status and predictors of mortality among multidrug-resistant tuberculosis patients treated in Saint Peter’s Specialized Hospital at Addis Ababa, Ethiopia, 2020. Methods. An institutional retrospective cohort study was conducted using all MDR-TB patients who were enrolled in Saint. Peter’s Specialized Hospital from January 01, 2015, to December 31, 2017. A pretested data extraction form that had 5 items for sociodemographic and 15 items for the measurement of clinical characteristics of 484 MDR-TB patients was used. STATA software version 14.2 was used for data cleaning and analysis. A variable that fitted in the bivariable Cox proportional hazard model at p value <0.25 was used in the final multivariable Cox proportional hazard model, and independent predictors of time to event were determined at a p value of 0.05. Result. A total of 484 patients were followed up for 5,078 person-months. Among the total patients, nearly half, 238 (48.8%), were males. The median age of patients was 30 years (interquartile range (IQR), 24–39), and 56 (11.6%) were aged between 1 and 19 years. During the follow-up period, 315 (65.1%) patients were cured, 125 (25.8%) completed treatment, 24 (5%) died, and 20 (4.1%) were lost to follow-up. The overall cumulative probability survival of the patients at the end of treatment was 94.85% (95% confidence interval (CI): 92.38%–96.53%). The independent predictors of time to death were being anemic (AHR = 3.65; 95% CI: 1.36, 9.79), having clinical complication (AHR = 3; 95% CI: 1.2, 7.5), and being HIV infected (AHR = 5.8; 95% CI: 2.2, 15.7). Conclusions. MDR-TB patients’ survival rate was high in St Peter’s Specialized Hospital. MDR-TB patients with anemia, HIV coinfection, and clinical complications had higher risk of mortality. So, prevention and controlling of anemia, HIV/AIDS, and clinical complications will reduce the mortality of MDR-TB patients.

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Intensive Phase Treatment Outcome and Associated Factors among Patients Treated for Multi Drug Resistant Tuberculosis in Ethiopia: A retrospective cohort study

Cited by 4 publications

References 13 publications

Poor treatment outcome and its predictors among drug-resistant tuberculosis patients in Ethiopia: A systematic review and meta-analysis

Poor treatment outcome and its predictors among drug-resistant tuberculosis patients in Ethiopia: A systematic review and meta-analysis

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

Survival Status and Predictors of Mortality among Multidrug-Resistant Tuberculosis Patients in Saint Peter’s Specialized Hospital, Addis Ababa, Ethiopia

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