Treatment outcomes of pulmonary multidrug-resistant tuberculosis;  10 year follow up study

Abstract The burden of multidrug-resistant tuberculosis (MDR-TB) related to mortality in resource-poor countries remains high. This study aimed to estimate the incidence and predictors of death among MDR-TB patients in central Ethiopia. A retrospective follow-up study was conducted at three hospitals in the Amhara region on 451 patients receiving treatment for MDR-TB from September 2010 to January 2017. Data were collected from patient registration books, charts and computer databases. Data were fitted to a parametric frailty model and survival was expressed as an adjusted hazard ratio (AHR) with a 95% confidence interval (CI). The median follow-up time of participants was 20 months (interquartile range: 12, 22) and 46 (10.20%) of patients died during this period. The incidence rate of mortality was 7.42 (95% CI 5.56–9.91)/100 person-years. Older age (AHR = 1.04, 95% CI 1.01–1.08), inability to self-care (AHR = 13.71, 95% CI 5.46–34.40), co-morbidity (AHR = 5.74, 95% CI 2.19–15.08), low body mass index (AHR = 4.13, 95% CI 1.02–16.64), acute lung complications (AHR = 4.22, 95% CI 1.66–10.70) and lung consolidation at baseline (AHR = 5.27, 95% CI 1.06–26.18) were independent predictors of mortality. Most of the identified predictor factors of death in this study were considered to be avoidable if the TB programme had provided nutritional support for malnourished patients and ensured a close follow-up of the elderly, and patients with co-morbidities.

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Adverse treatment outcomes in multidrug resistant tuberculosis go beyond the microbe-drug interaction: Results of a multiple correspondence analysis.

Biomédica ◽

10.7705/biomedica.5072 ◽

2020 ◽

Vol 40 (4) ◽

pp. 616-625

Author(s):

Ángela Tobón ◽

Johana Rueda ◽

Diego H. Cáceres ◽

Gloria I. Mejía ◽

Elsa M. Zapata ◽

...

Keyword(s):

Treatment Outcomes ◽

Treatment Success ◽

Multidrug Resistant ◽

Chronic Obstructive ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Mdr Tb ◽

Poor Outcomes ◽

Lost To Follow Up

Introduction: Multidrug-resistant tuberculosis treatment is effective in 50% of patients due to several factors including antibiotic susceptibility of the microorganism, adverse treatment reactions, social factors, and associated comorbidities.Objectives: In this study, we describe the demographics, clinical characteristics, and factors associated with treatment outcomes in multidrug-resistant tuberculosis (MDR-TB) patients in Medellín, Colombia.Materials and methods: We conducted a retrospective analysis using data from patients diagnosed with MDR-TB attending Hospital La María in Medellín, Colombia, for treatment between 2010 and 2015. Patients were categorized as having successful (cured) or poor (failure, lost to follow-up, and death) treatment outcomes. Associations between demographic, clinical factors, laboratory results, treatment outcomes, and follow-up information were evaluated by univariate, multivariate, and multiple correspondence analyses.Results: Of the 128 patients with MDR-TB, 77 (60%) had successful outcomes. Of those with poor outcomes, 26 were lost to follow-up, 15 died, and 10 were treatment failures. Irregular treatment, the presence of comorbidities, and positive cultures after more than two months of treatment were associated with poor outcomes compared to successful ones (p<0.05 for all). The multiple correspondence analyses grouped patients who were lost to follow-up, had HIV, and drug addiction, as well as patients with treatment failure, irregular treatment, and chronic obstructive pulmonary disease.Conclusion: The recognition of factors affecting treatment is essential and was associated with treatment outcomes in this series of patients. Early identification of these factors should increase the rates of treatment success and contribute to MDR-TB control.

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Treatment Outcomes of Multidrug-Resistant Tuberculosis in Taiwan: Tackling Loss to Follow-up

Clinical Infectious Diseases ◽

10.1093/cid/ciy066 ◽

2018 ◽

Vol 67 (2) ◽

pp. 202-210 ◽

Cited By ~ 10

Author(s):

Ming-Chih Yu ◽

Chen-Yuan Chiang ◽

Jen-Jyh Lee ◽

Shun-Tien Chien ◽

Chou-Jui Lin ◽

...

Keyword(s):

Treatment Outcomes ◽

Multidrug Resistant ◽

Loss To Follow Up ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis

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Effects of Multidrug Resistant Tuberculosis Treatment on Patients’ Health Related Quality of Life: Results from a Follow Up Study

PLoS ONE ◽

10.1371/journal.pone.0159560 ◽

2016 ◽

Vol 11 (7) ◽

pp. e0159560 ◽

Cited By ~ 11

Author(s):

Nafees Ahmad ◽

Arshad Javaid ◽

Syed Azhar Syed Sulaiman ◽

Anila Basit ◽

Afsar Khan Afridi ◽

...

Keyword(s):

Quality Of Life ◽

Multidrug Resistant ◽

Health Related Quality ◽

Follow Up Study ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Related Quality ◽

Health Related

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Factors influencing the length of hospital stay during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara regional state hospitals, Ethiopia: a retrospective follow up study

BMC Public Health ◽

10.1186/s12889-020-09324-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Koku Sisay Tamirat ◽

Gashaw Andargie ◽

Yaregal Animut Babel

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Multidrug Resistant ◽

Intensive Phase ◽

State Hospitals ◽

Follow Up Study ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Factors Influencing

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Factors influencing length of hospital stay during the intensive phase of multidrug resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: retrospective follow up study

10.21203/rs.3.rs-15610/v1 ◽

2020 ◽

Author(s):

Koku Sisay Tamirat ◽

Gashaw Andargie ◽

Yaregal Animut Babel

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Multidrug Resistant ◽

Tuberculosis Treatment ◽

Intensive Phase ◽

Follow Up Study ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Hospital Stays

Abstract Background: Tuberculosis (TB) generally considered as an ambulatory disease. However, hospitalization remains an important component for isolation and medical stabilization of patients. Hence, this study aimed to identify factors influencing the length of hospital stay during the intensive phase of multidrug resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: retrospective follow up study.Methods: An institution based retrospective follow up study was conducted at three hospitals, namely the University of Gondar comprehensive specialized, Borumeda and Debremarkos referral from September 2010 to December 2016 (n=465). Data were extracted from hospital admission/discharge logbooks and individual patient medical charts. Logistic regression was used to identify factors associated with longer hospital stays during the intensive phase of multidrug resistant tuberculosis treatment.Result: Most patients (92.5%) had a pulmonary form of multidrug resistant tuberculosis and a quarter of them HIV co-infections. The median length of hospital stay was 61 (interquartile range 34 to 101) days. The pulmonary form of tuberculosis (Adjusted odds ratio [AOR], 3.20, 95% confidence interval [CI]; 1.28 to 7.96), treated at the University of Gondar (AOR= 2.11, 95%CI; 1.02 to 4.41) and Borumeda Hospital (AOR= 3.59, 95%CI; 1.67 to 7.72), functional status of ambulatory (AOR=2.25, 95% CI; 1.19 to 4.27) and bedridden (AOR= 3.39, 95%CI; 1.57 to 7.35), and reported adverse drug reactions (AOR=2.54, 95%CI; 1.60 to 4.02) were significant predictors of extended hospital stays.Conclusion: The study revealed that longer hospital stay and significant differences were observed among hospitals. Decreased functional status at admission, pulmonary form of tuberculosis and reported adverse drug reactions were determinants of longer hospital stays. This underscores the importance of early case detection and prompt treatment of adverse effects.

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