Publications & Reports

Treatment outcomes in patients with multidrug-resistant tuberculosis in Northwest Ethiopia.

Alene KA, Viney K, McBryde ES, Tesfahun A, Clements AC

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 Northwest Ethiopia. METHODS: Retrospective cohort study of all MDR-TB patients who were enrolled at Gondar University Hospital since the establishment of the MDR-TB program in September 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, 4 (2%) experienced treatment failure, 27 (11%) were lost to follow up, 6 (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 2010-2012, to 12% per PY during 2013-2015. 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 Northwest 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 socioeconomic and biological risk factors.

Link to publisher’s web site

Publication

  • Journal: Tropical Medicine and International Health
  • Published: 01/01/2017
  • Volume: 22
  • Issue: 3
  • Pagination: 351-362

Program

Health Issue