Predictors of Outcome in Drug Resistant Tuberculosis Patients

Periasamy, Arivudainambi Veerappan

doi:10.4172/2161-105x.1000391

Cited by 4 publications

(5 citation statements)

References 27 publications

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“…Some of the factors that have been found to be associated with successful or unsuccessful MDR-TB treatment outcome include patient age, 15 gender, 16 pretreatment body mass index (BMI) 17 and body weight, drug adherence, 18 positive smear at the start of treatment, history of TB, 19 smoking, 16 alcohol consumption, 20 and comorbidities or underlining health conditions such as HIV 21 and diabetes. 22 However, other studies 15 21 23 have reported findings contrary to the above-mentioned factors. For instance, Elliott et al found no association between MDR-TB treatment outcome and positive smear at the start of treatment and HIV coinfection.…”

Section: Introductionmentioning

confidence: 91%

Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study

et al. 2022

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ObjectiveAlthough several studies have assessed treatment outcomes of drug-susceptible tuberculosis (TB) in Ghana, very little has been done in the area of multidrug-resistant TB (MDR-TB). The aim of this study was to determine treatment outcomes and associated factors among patients treated for MDR-TB in the Ashanti Region, Ghana.DesignA retrospective, cross-sectional analysis.SettingThe study was conducted in the Ashanti Region, the second most populous region in Ghana. The regional MDR-TB register, which contains information on all patients with MDR-TB being treated at the various TB centres in the region, was analysed between February and May 2021.ParticipantsThe participants consisted of all registered patients with MDR-TB who were placed on treatment between 1 January 2015 and 31 December 2020. Patients were included in the analysis if their treatment outcome had been assigned. Patients with no record of treatment outcome were excluded from the study.Outcome measuresThe main outcome variable for the study was MDR-TB treatment outcome, standardised as ‘cured’, ‘treatment completed’, ‘treatment failure’, ‘died’ and ‘lost to follow-up’. A logistic regression model was fitted for factors associated with the outcome measure.ResultsOut of 159 patients included in the analysis, 86 (54.1%) were declared cured, 28 (17.6%) completed their treatment successfully, 6 (3.8%) were declared treatment failure, 12 (7.5%) were lost to follow-up and 27 (17.0%) died. The overall treatment success rate was 71.7%. Patients who were female (adjusted OR (AOR)=1.27, 95% CI: 1.18 to 1.39, p=0.023), younger (AOR=0.53, 95% CI: 0.19 to 2.11, p=0.012), had a higher level of education (AOR=1.12, 95% CI: 0.65 to 1.90, p=0.034), had a baseline body mass index of 18.5 kg/m2 or above (AOR=1.57, 95% CI: 1.23 to 2.47, p=0.011) and those who did not have a history of TB (AOR=0.47, 95% CI: 0.10 to 0.75, p=0.028) were more likely to have successful MDR-TB treatment outcomes.ConclusionsFavourable treatment outcomes for patients with MDR-TB can be achieved in a resource-limited country. Although the recommended WHO target of ≥75% was not met, the current result (71.7% treatment success rate) is still commendable considering all the challenges associated with TB treatment in Ghana.

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Section: Introductionmentioning

confidence: 91%

Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study

et al. 2022

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“…Smoking increases the risk of TB as well as mortality. Strict glycemic control, switching to an extremely drug resistant tuberculosis (XDR-TB) regimen from MDR-TB in preXDR-TB, and drug rehabilitation should be carried out in drug resistant TB patients [ 23 ]. Overall risk of TB in persons with DM is two to three times higher than the general population since chronic hyperglycemia has an association with treatment outcome and prognosis of TB.…”

Section: Introductionmentioning

confidence: 99%

A Saudi Arabian Public Health Perspective of Tuberculosis

Saati

Khurram

Faidah

et al. 2021

IJERPH

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Tuberculosis is a global health challenge due to its spreading potential. The Kingdom of Saudi Arabia (KSA) faces a challenge in the spread of tuberculosis from migrant workers, but the foremost threat is the huge number of pilgrims who travel to visit sacred sites of the Islamic world located in the holy cities of Makkah and Al Madina. Pilgrims visit throughout the year but especially in the months of Ramadan and Zul-Hijah. The rise of resistance in Mycobacterium tuberculosis is an established global phenomenon that makes such large congregations likely hotspots in the dissemination and spread of disease at a global level. Although very stringent and effective measures exist, the threat remains due to the ever-changing dynamics of this highly pathogenic disease. This overview primarily highlights the current public health challenges posed by this disease to the Saudi health system, which needs to be highlighted not only to the concerned authorities of KSA, but also to the concerned global quarters since the pilgrims and migrants come from all parts of the world with a majority coming from high tuberculosis-burdened countries.

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“…Moreover, other studies have focused on the predictors of unsuccessful treatment outcomes, such as extensive drug resistance [8, 11, 12], low BMI [13], hypoalbuminemia [11], comorbidities such as diabetes [11, 14], and cavitary disease [11, 13]. Others were HIV coinfection, positive smear at the start of treatment, and previous history of TB treatment [4, 11, 15], smoking [16, 17], pre-XDRTB, and diabetes mellitus [17],…”

Section: Introductionmentioning

confidence: 99%

Predictors of Treatment Outcomes among Multidrug Resistant Tuberculosis Patients in Tanzania

Leveri

Lekule²,

Mollel

et al. 2019

Tuberculosis Research and Treatment

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Background. According to World Health Organization (WHO) the final multidrug resistant tuberculosis (MDRTB) treatment outcome is the most important direct measurement of the effectiveness of the MDRTB control program. Literature review has shown marked diversity in predictors of treatment outcomes worldwide even among the same continents. Therefore, findings could also be different in Tanzanian context, where the success rate is still lower than the WHO recommendation. This study sought to determine the predictors of treatment outcomes among MDRTB patients in Tanzania in order to improve the success rate. Methodology. This was a retrospective cohort study, which was conducted at Kibong’oto Infectious Diseases Hospital (KIDH) in Tanzania. Patients’ demographic and clinical parameters were collected from the MDRTB registry and clinical files. Then, a detailed analysis was done to determine the predictors of successful and unsuccessful MDRTB treatment outcomes. Results. Three hundred and thirty-two patients were diagnosed and put on MDRTB treatment during the year 2009 to 2014. Among them, males were 221 (67%), and 317 (95.48%) were above 18 years of age, mean age being 36.9 years. One hundred and sixty-one patients (48.5%) were living in Dar es Salaam. The number of MDRTB patients has increased from 16 in 2009 to 132 in 2014. Majority of patients (75.7%) had successful treatment outcomes. The following predictors were significantly associated with MDRTB cure: presence of cavities in chest X-rays (aOR 1.89, p value 0.002), low BMI (aOR 0.59, p value 0.044), and resistance to streptomycin (aOR 4.67, p value 0.007) and ethambutol (aOR 0.34, p value 0.041). Smoking and presence of cavities in chest X-rays were associated with MDRTB mortality, aOR 2.31, p value 0.043 and aOR 0.55, p value 0.019, respectively. Conclusion. The study indicated that overall number of MDRTB patients and the proportion of successful treatment outcomes have been increasing over the years. The study recommends improving nutritional status of MDRTB patients, widespread antismoking campaign, and close follow-up of patients with ethambutol resistance.

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Predictors of Outcome in Drug Resistant Tuberculosis Patients

Cited by 4 publications

References 27 publications

Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study

Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study

A Saudi Arabian Public Health Perspective of Tuberculosis

Predictors of Treatment Outcomes among Multidrug Resistant Tuberculosis Patients in Tanzania

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