Treatment outcomes of patients with MDR-TB and its determinants at referral hospitals in Ethiopia

Abstract

Background There is limited empirical evidence in Ethiopia on the determinants of treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) who were enrolled to second-line anti-tuberculosis drugs. Thus, this study investigated the determinants of treatment outcomes in patients with MDR-TB at referral hospitals in Ethiopia. Design and methods This study was underpinned by a cross-sectional quantitative research design that guided both data collection and analysis. Data is collected using structured questionnaire and data analyses was performed using the Statistical Package for Social Sciences. Multi-variable logistic regression was used to control for confounders in determining the association between treatment outcomes of patients with MDR-TB and selected predictor variables, such as co-morbidity with MDR-TB and body mass index. Results From the total of 136 patients with MDR-TB included in this study, 31% had some co-morbidity with MDR-TB at baseline, and 64% of the patients had a body mass index of less than 18.5 kg/m2. At 24 months after commencing treatment, 76 (69%), n = 110), of the patients had successfully completed treatment, while 30 (27%) died of the disease. The odds of death was significantly higher among patients with low body mass index (AOR = 2.734, 95% CI: 1.01–7.395; P<0.048) and those with some co-morbidity at baseline (AOR = 4.260, 95%CI: 1.607–11.29; p<0.004). Conclusion The higher proportion of mortality among patients treated for MDR-TB at Adama and Nekemte Hospitals, central Ethiopia, is attributable to co-morbidities with MDR-TB, including HIV/AIDS and malnutrition. Improving socio-economic and nutritional support and provision of integrated care for MDR-TB and HIV/AIDS is recommended to mitigate the higher level of death among patients treated for MDR-TB.

Sputum smear conversion and treatment outcomes among drug-resistant pulmonary tuberculosis patients in eastern Ethiopia: A 9-years data analysis

“…The overall favorable treatment outcome was 66.30%. This is comparable with the study conducted in Ethiopia ( 19 ). The study revealed that Khat chewing, baseline smear result greater than 2+, poor anti-TB adherence and bilateral lung cavity had a significant association with unfavorable DR-TB treatment outcome.…”

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

“…A study conducted from a teaching and referral hospital in Wolayta Sodo, Ethiopia, reported similar findings. 39 However, studies in Ethiopia and abroad reported that undernutrition, 31 , 33 HIV infection, 21 , 26 and history of anti-TB drug use 40 were risk factors for unsuccessful treatment outcomes such as treatment failure and death. In the present study, there were a considerable number of patients with unknown HIV and BMI status, which may have underestimated the frequency of HIV infection and BMI, respectively.…”

The Targeted Maximum Likelihood estimation to estimate the causal effects of the previous tuberculosis treatment in Multidrug-resistant tuberculosis in Sudan

“…Six covariates (w1 to w6) including age, time to reach health facility, number of times stop tuberculosis treatment, gender, education level, and contact with MDR-TB were determined. Other confounders of the MDR-TB include HIV [ 14 ], malnutrition, and comorbidities [ 15 ]. We assumed that history of previous TB treatment was independent from the occurrence of MDR-TB while controlling for other confounders (w) to achieve conditional exchangeability between exposure and outcome.…”