Abstract
Background
Multi-drug resistant Tuberculosis (MDRTB) is a strain of Mycobacterium tuberculosis that is resistant to at least Rifampicin and Isoniazid drugs. The treatment success rate for MDRTB cases is lower than for drug susceptible TB. Monitoring the early treatment outcome and better understanding the specific reasons for early unfavorable treatment outcome are important to evaluate the effectiveness of tuberculosis control and preventing the emergence of extremely drug resistant tuberculosis. However, this information is scarce in Ethiopia. Therefore, this study aimed to determine the intensive phase treatment outcome and factors contributing among patients treated for MDRTB in Ethiopia.
Methods
A 6 year (2009 to 2014) retrospective cohort record review was conducted in fourteen treatment initiating centers in Ethiopia. The records of 751 MDRTB patients were randomly selected using simple random sampling. Data were collected using a pre-tested and structured checklist. Multivariable multinomial logistic regression model was undertaken to identify the contributing factors.
Results
At the end of the intensive phase, 17.3% of MDRTB patients had an unfavorable treatment outcome while 16.8% had an unknown outcome with the rest having a favorable outcome. The median duration of the intensive phase was 9.0 months (IQR 8.04-10.54). Having an unfavorable intensive phase treatment outcome was found to be more common among older aged [ARRR= 1.047, 95% CI (1.024, 1.072)] and those without a history of hypokalemia [ARRR=0.512, 95% CI (0.280, 0.939)]. Having an unknown intensive phase treatment outcome was found to be more common among those treated under the ambulatory care model [ARRR=3.2, 95% CI (1.6, 6.2)], rural dwellers [ARRR= 0.370, 95% CI (0.199, 0.66)], those without a treatment supporter [ARRR=0.022, 95% CI (0.002, 0.231)], and those with resistance to a limited number of drugs.
Conclusion
We observed a higher than anticipated rate of unfavorable and unknown treatment outcomes in this study. To improve favorable treatment outcome more emphasis should be given to conducting all scheduled laboratory monitoring tests, assignment of trained treatment supporters and ensuring complete recording and reporting which could be enhanced by quarterly cohort review. Older aged and rural patients need special attention. Furthermore, the sample referral network should be strengthened.
P96 Characteristics and outcomes of multi-drug resistant tuberculosis patients in a major urban centre in the UK: Abstract P96 Table 1.
