Treatment interruption and associated factors among patients registered on drug-resistant tuberculosis treatment in Amhara regional state, Ethiopia: 2010–2017

Abstract

Background Drug-Resistant Tuberculosis (DR-TB) is a rising threat of the TB control program caused mainly by treatment interruption in Ethiopia. The success of the current treatment regimen for DR-TB is poor partly due to a high treatment interruption rate. Thus, this study assessed treatment interruption and associated factors among DR-TB patients. Methods An institution-based cross-sectional study was conducted among 550 DR-TB patients who have initiated treatment from September 2010 to December 2017. Data were entered using Epi Data version 4.200 and exported to STATA version 14 for analysis. A bi-variable logistic regression model was first fitted, and variables having a p-value < 0.2 in the bi-variable analysis were entered into the multivariable logistic regression model. Crude and Adjusted Odds Ratios (COR and AOR) with 95% confidence interval (CI) were used to determine the strength of association between the treatment interruption and independent variables. Variables with p-value <0.05 in the multi-variable model were considered as statistically significant predictors of treatment interruption.

Prognostication of treatment non-compliance among patients with multidrug-resistant tuberculosis in the course of their follow-up: a logistic regression–based machine learning algorithm

“…A lack of money caused people to go without meals and pay for transportation, which made it difficult for TB patients to continue receiving treatment. This finding was in line with a systematic review and meta-analysis conducted in China, Brazil, and Myanmar and a systematic review conducted in developing countries ( 19 , 23 , 29 – 31 ).…”

“…In low-income countries such as Ethiopia, which is beset with a myriad problems, treatment non-compliance continues to prevail and increases the risk of drug resistance ( 18 , 23 ). The magnitude of treatment non-compliance identified in this study is higher than that found in a study conducted in Southern Ethiopia (24.5%) and the Amhara region (14.5%) ( 15 , 19 ).…”

A modeling‐based proposal for safe and efficacious reintroduction of bedaquiline after dose interruption: A population pharmacokinetics study

“…Interruptions of MDR‐TB treatment are relatively common and can occur due to multiple reasons, such as severe adverse events, treatment adherence issues, or lack of access to drugs. The proportion of patients with MDR‐TB where treatment was interrupted at least once, varies from 6.1% 20 over 14.6% 21 to 93.0% 22 across different studies and settings. Due to the long terminal half‐life and toxicity concerns, re‐introducing BDQ after multiple dose interruption is not intuitive and there is a lack of guidelines addressing how treatment should be resumed.…”

Factors associated with screening failure and study withdrawal in multidrug-resistant TB

“…The treatment period is usually even greater for trials evaluating treatments for drug-resistant TB (DR-TB); additionally, drugs used for DR-TB are likely to cause more adverse events and lead to loss of follow-up. 6,7 While alternative designs are implemented to adapt to the challenges currently posed by the DR-TB epidemic, 8 robust participant recruitment and study retention are markers of study quality.…”