Predictors of Treatment Outcomes of Multi-Drug-Resistant Tuberculosis: A Retrospective Hospital-Based Study in a Tertiary Care Teaching Hospital of South Odisha
Creators
- 1. Department of Pharmacology, MKCG Medical College & Hospital, Berhampur, Odisha.
Description
Objective: To assess the predictors of treatment outcomes of multidrug-resistant tuberculosis cases treated according to the Revised National Tuberculosis Control Programme. Materials and Methods: A retrospective study was carried out in the Department of Pulmonary Medicine of MKCG MCH. All patients enrolled for multidrug-resistant tuberculosis management between January 2019 to December 2019 were included in the study. Demographic details, symptoms, and sputum examination findings were collected from the multidrug-resistant tuberculosis register. Besides, resistance patterns, adverse drug reactions, medication adherence and final treatment outcomes were noted in a predesigned case record form. Data were analyzed using suitable statistical tests. Result: Out of 95 patients, males outnumbered females. Most of the cases belonged to rural areas (89%). The mean age of study participants was 39.1 years. The most common resistance pattern (60%) was to Isoniazid and Rifampicin (HR). Among all, 52% were completely cured. 23% were defaulters, and 3% of them had treatment failure. Death was recorded in 21% of cases. The most common Adverse Drug Reaction (ADR) associated with the medications was joint pain. Alcohol and smoking habits, concomitant medications for other co-existing diseases, poor medication adherence, and occurrence of ADRs were the independent negative predictors (P value<0.05) of successful outcomes. Sputum conversion within 3 months positively predicted successful treatment outcomes (P value<0.01). Age, gender, geographical area, and pattern of anti-tubercular drug resistance did not influence the treatment outcomes. Conclusion: Our study observations revealed that the treatment outcomes of MDR TB as per PMDT guidelines were low. It seems there is a need for conducting more programs among DOTS care providers regarding the awareness of risk factors of poor outcomes and patient health education.
Abstract (English)
Objective: To assess the predictors of treatment outcomes of multidrug-resistant tuberculosis cases treated according to the Revised National Tuberculosis Control Programme. Materials and Methods: A retrospective study was carried out in the Department of Pulmonary Medicine of MKCG MCH. All patients enrolled for multidrug-resistant tuberculosis management between January 2019 to December 2019 were included in the study. Demographic details, symptoms, and sputum examination findings were collected from the multidrug-resistant tuberculosis register. Besides, resistance patterns, adverse drug reactions, medication adherence and final treatment outcomes were noted in a predesigned case record form. Data were analyzed using suitable statistical tests. Result: Out of 95 patients, males outnumbered females. Most of the cases belonged to rural areas (89%). The mean age of study participants was 39.1 years. The most common resistance pattern (60%) was to Isoniazid and Rifampicin (HR). Among all, 52% were completely cured. 23% were defaulters, and 3% of them had treatment failure. Death was recorded in 21% of cases. The most common Adverse Drug Reaction (ADR) associated with the medications was joint pain. Alcohol and smoking habits, concomitant medications for other co-existing diseases, poor medication adherence, and occurrence of ADRs were the independent negative predictors (P value<0.05) of successful outcomes. Sputum conversion within 3 months positively predicted successful treatment outcomes (P value<0.01). Age, gender, geographical area, and pattern of anti-tubercular drug resistance did not influence the treatment outcomes. Conclusion: Our study observations revealed that the treatment outcomes of MDR TB as per PMDT guidelines were low. It seems there is a need for conducting more programs among DOTS care providers regarding the awareness of risk factors of poor outcomes and patient health education.
Files
IJPCR,Vol15,Issue11,Article178.pdf
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Additional details
Dates
- Accepted
-
2023-10-30
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue11,Article178.pdf
- Development Status
- Active
References
- 1. Leveri, T.H. et al. (2019) 'Predictors of treatment outcomes among multidrug-resistant tuberculosis patients in Tanzania', Tuberculosis Research and Treatment, 2019, pp. 1–10. doi:10.1155/2019/3569018. 2. WHO, "The Global Plan to Stop TB: 2011- 2015," 2010,http://www.stoptb.org 3. https://www.who.int/teams/global-tubercul osis-programme/tb-reports/global-tuberculosisreport-2022/tb-disease-burden/2-3-drug-resistant-tb ;assessed on 20th January 2023 4. WHO, GLOBAL TUBERCULOSIS REPORT 2016, 2016. 5. Lange C, Abubakar I, Alffenaar J W, et al. Management of patients with multidrug-resistant/extensively drug-resistant tuberculosis in Europe: A TBNET Consensus Statement. Eur Respir J 2014; 44: 23–63. 6. WHO, "Multidrug-Resistant Tuberculosis (MDR-TB) Indicators," 2010, https://apps. who.int/iris/bitstream/handle/10665/70484/WHO HTM TB 2010.11 eng.pdf;jsessionid= 5E41E5961BFB7D932AA29BAE85D057DC? sequence=1. 7. O. S. Elmi, H. Hasan, S. Abdullah, M. Z. Mat Jeab, Z. BA, and N. N. Naing, "Treatment outcomes of patients with multi-drug resistant tuberculosis (MDR- TB) compared with NonMDRTB infections in peninsular Malaysia," Malaysian Journal of.Medical Sciences, vol. 23, no. 4, pp. 17–25, 2016 8. WHO, "WHO treatment guidelines for drug-resistant tuberculosis,"2022. 9. Wrohan, I. et al. (2022) 'Predictors of treatment outcomes among patients with multidrug-resistant tuberculosis in Vietnam: A retrospective cohort study,' BMC Infectious Diseases, 22(1). doi:10.1186/s12879-021-06992-x. 10. Olna Oliveira, Miguel Villar, Raquel Duarte.Predictors of treatment outcome in multidrug-resistant tuberculosis European Respiratory Journal 2011 38: p3296 11. Netsanet Aragaw, Mekonnen Teferi, Oumer Ali, Emawayish Tesema, Samuel Ayele, Habtamu Jarso, Kifle Woldemichael. Treatment Outcomes and Predictors of Outcome in Multidrug Resistance Tuberculosis (MDR-TB) Cohort of Patients in Addis Ababa, Ethiopia. American Journal of Health Research. Vol. 9, No. 5, 2021, pp. 204-212. doi: 10.11648/j.ajhr. 20210905.19 12. Anley, D.T. et al. (2022) 'Development and validation of a nomogram for the prediction of unfavourable treatment outcome among multidrug resistant tuberculosis patients in North West Ethiopia: An application of prediction modelling', Infection and Drug Resistance, Volume 15, pp. 3887–3904. doi:10.2147/ idr. s372351. 13. Tola H, Holakouie,Naieni K, Mansournia MA, et al. National treatment outcome and predictors of death and treatment failure in multidrugresistant tuberculosis in Ethiopia: a 10-year retrospective cohort study. BMJ Open 2021;11:e040862. doi:10.1136/ bmjopen-2020- 040862