Treatment outcomes in patients with multidrug-resistant tuberculosis in north-west Ethiopia

Treatment outcomes in patients with multidrug-resistant tuberculosis in north-west Ethiopia. Kefyalew Addis Alene, Kerri Viney, Emma S. McBryde, Adino Tesfahun Tsegaye, Archie C. A. Clements. Tropical Medicine and International Health. First published: 6 January 2017. Volume 22, Issue 3 March 2017, pages 351–362. doi: 10.1111/tmi.12826


Abstract

Objective: Multidrug-resistant tuberculosis (MDR-TB) is an emerging public health problem in Ethiopia. The aim of this study was to assess MDR-TB treatment outcomes and determine predictors of poor treatment outcomes in north-west Ethiopia.
Methods: A retrospective cohort study was conducted using all MDR-TB patients who were enrolled at Gondar University Hospital since the establishment of the MDR-TB programme in 2010. A Cox proportional hazard model was used to identify the predictors of time to poor treatment
outcomes, which were defined as death or treatment failure.
Results: Of the 242 patients who had complete records, 131 (54%) were cured, 23 (9%) completed treatment, 31 (13%) died, four (2%) experienced treatment failure, 27 (11%) were lost to follow-up, six (2%) transferred out, and 20 (8%) were still on treatment at the time of analysis. The overall
cumulative probability survival of the patients at the end of treatment (which was 24 months in duration) was 80% (95% CI: 70%, 87%). The proportion of patients with poor treatment outcomes increased over time from 6% per person-year (PY) during 20102012, to 12% per PY during 20132015. The independent predictors of time to poor treatment outcome were being anaemic [AHR = 4.2; 95% CI: 1.1, 15.9] and being a farmer [AHR = 2.2; 95% CI: 1.0, 4.9].
Conclusions: Overall, in north-west Ethiopia, the MDR-TB treatment success rate was high. However, poor treatment outcomes have gradually increased since 2012. Being a farmer and being anaemic were associated with poor treatment outcomes. It would be beneficial to assess other risk
factors that might affect treatment outcomes such as co-infection with malaria, poverty and other socio-economic and biological risk factors.

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