Multidrug-Resistant Tuberculosis Treatment Outcome and Associated Factors at the University of Gondar Comprehensive Specialized Hospital: A Ten-Year Retrospective Study

Abstract

Background Multidrug-resistant tuberculosis (MDR-TB) remains a public health crisis and a health security threat worldwide. Poor public health infrastructure, inefficient infection control and mismanagement of TB treatment are among the reasons for the continuous emergence and spread of drug-resistant TB (DR-TB). The final treatment outcome is the most direct measurement of TB control programs. Therefore, this study sought to determine the proportions and predictors of TB treatment outcomes among MDR/RR-TB treated patients. Methods A 10-year, 2011 to 2021, hospital-based retrospective cohort study was conducted at the University of Gondar Comprehensive Specialized Hospital. The records of 408 MDR-TB patients, 389 with treatment outcome and 19 on treatment, were collected using a structured checklist. Results A total of 389 patients with a recorded MDR/RR-TB treatment outcome were included. The treatment success rate was 77.12%, with 58.35% cured and 18.76% treatment completed. The proportion of death rate, treatment default loss to follow-up, treatment failure, and unknown treatment outcome was 9.25%, 6.94%, 3.1%, and 3.6%, respectively. Regarding the patient category, the most successful treatment outcome (83.5%) came from patients diagnosed with relapse cases, followed by new cases (81.8%). An unsuccessful treatment outcome was significantly associated with patients aged >44 years (AOR, 3.3, 95% CI = 1.55–6.99). Conclusion and Recommendations This study indicated that nearly 23% of MDR/RR-TB patients had unsuccessful treatment outcomes and being older was significantly correlated with these outcomes. For better outcomes, it is recommended to strengthen combined treatment adherence interventions and evaluate treatment regimens and administration options. A prospective cohort study may be required to investigate the full range of potential causes of unfavorable outcomes.

Treatment outcome of drug-resistant tuberculosis (DR-TB) following uptake of universal drug susceptibility testing: A record review from a nodal DR-TB center

“…5,7,8 This age group of young adults (18-30 years) (31.8%) demonstrated unfavorable treatment outcomes which may have certain possibilities like exposed to more infectious pathogens, poor treatment compliance as a result of the lengthy treatment period, and having to forgo high-risk behaviors such as smoking and alcoholism, which weakens the immunity, ultimately led to poor treatment adherence, which has been shown to have negative effects on health, while Belachew et al, from Ethiopia in a 10 year retrospective review, found old age to be significantly associated with unsuccessful treatment outcome. 9 Small sample size in the above cited studies and the present study could be a reason for not getting enough power to demonstrate the effect of age or sex on treatment outcome. 5,7,8 Majority of the DR-TB isolates in this study belong to below poverty line (62.2%), although, showed treatment success rate on higher side, not statistically significant with the treatment outcome, and might be with the reason of timely and adequate implementation of the U-DST to provide accurate diagnostic services and modification of the treatment regimen.…”

Survival status and risk factors for mortality among multidrug-resistant tuberculosis patients in Addis Ababa, Ethiopia: A retrospective follow-up study

“…The current study found 66.1% of successful treatment outcomes, which is consistent with the studies done in Northwest Ethiopia 63% [33] and Haiti, 66.4% [34] . However, it was lower than the national treatment success rate of 75.7% [35] , 81.1% in Uganda [36] , 76.9% in Addis Ababa [37] and 77.1% in Gonder compressive Specialized Hospital [38] . The difference in the current success rate could be attributed to progress over time, a patient condition during admission, program organization, setting, and a variety of other factors.…”

Low body mass index as a predictor of sputum culture conversion and treatment outcomes among patients receiving treatment for multidrug-resistant tuberculosis in Lesotho

“…Despite the recent improvements in the treatment of multidrug- or rifampicin-resistant and resistant tuberculosis (MDR/RR-TB), not all patients experience treatment success [ 1 , 2 ]. Even among patients receiving all-oral and/or shortened regimens, those living with HIV or advanced TB experience a higher risk of unfavourable treatment outcomes.…”