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

PLoS One. 2022 Feb 17;17(2):e0262318. doi: 10.1371/journal.pone.0262318. eCollection 2022.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / therapeutic use*
  • Cross-Sectional Studies
  • Ethiopia / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / drug effects*
  • Mycobacterium tuberculosis / isolation & purification
  • Referral and Consultation / statistics & numerical data*
  • Risk Factors
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / epidemiology
  • Tuberculosis, Multidrug-Resistant / microbiology
  • Young Adult

Substances

  • Antitubercular Agents

Grants and funding

During the time the research was conducted MKW was employed to Abt Associates Inc. operating in Ethiopia. The funder provided support in the form of salaries for authors (MKW) but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘authors contributions section.