Predictors of Treatment Outcomes among Multidrug Resistant Tuberculosis Patients in Tanzania

Abstract

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.

Multi-Drug Resistant Tuberculosis Treatment Outcome and Associated Factors in Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study

“…Patients who have a history of second-line anti-TB drug resistance were more likely to have poor treatment outcomes. The nding of this study is in line with studies done in India, Pakistan, and Tanzania [14,15,16].…”

Unfavorable outcomes to second-line tuberculosis therapy among HIV-infected versus HIV-uninfected patients in sub-Saharan Africa: A systematic review and meta-analysis

“…The study participants for ten of the included studies [ 22 , 26 – 34 ] were mixed-age patients; for 7 of the included studies [ 23 – 25 , 35 – 38 ] were adults; for one of the included study [ 39 ] were adolescents and adults, and for the rest one of the included study [ 40 ] were children. Eleven (n = 11) of the included studies were from southern region of SSA [ 23 , 24 , 26 , 27 , 32 , 34 – 37 , 39 , 40 ], while 6 [ 25 , 28 – 31 , 33 ] and 2 [ 22 , 38 ] of them were from eastern and western regions, respectively ( Table 1 ).…”

Determinants of Successful Tuberculosis Treatment Outcome in a State University Teaching Hospital in South East, Nigeria: A 5 Year Retrospective Study

“…This is similar to a study in Tanzania that found that patients with cavities on chest X ray had better treatment outcomes but dissimilar to a study in Egypt where patients with advanced disease on chest X ray had worse outcomes. A different study in Malaysia revealed no significant associations between patients with chest x ray findings and treatment outcomes [30,28,27]. This finding could be as result of the different variations in chest X ray interpretation among radiologists and radiographers.…”