Predictors of Treatment Outcomes among Multidrug Resistant Tuberculosis Patients in Tanzania

Tamary Henry Leveri , 1,2 Isack Lekule, 2 Edson Mollel,1,3 Furaha Lyamuya, 1 and Kajiru Kilonzo, 1
Publication year: 

Background. According to World Health Organization (WHO) the hnal multidrug resistant tuberculosis (MDRTB) treatmentoutcome is the most important direct measurement of the eiectiveness of the MDRTB control program. Literature review hasshown marked diversity in predictors of treatment outcomes worldwide even among the same continents. Terefore, hndingscould also be diierent in Tanzanian context, where the success rate is still lower than the WHO recommendation. Tis studysought to determine the predictors of treatment outcomes among MDRTB patients in Tanzania in order to improve the successrate. Methodology. Tis was a retrospective cohort study, which was conducted at Kibong’oto Infectious Diseases Hospital (KIDH)in Tanzania. Patients’ demographic and clinical parameters were collected from the MDRTB registry and clinical hles. Ten, adetailed analysis was done to determine the predictors of successful and unsuccessful MDRTB treatment outcomes. Results.Treehundred and thirty-two patients were diagnosed and put on MDRTB treatment during the year 2009 to 201f. Among them, maleswere 221 (46%), and 716 (93.f8%) were above 18 years of age, mean age being 74.9 years. One hundred and sixty-one patients (f8.3%)were living in Dar es Salaam. Te number of MDRTB patients has increased from 14 in 2009 to 172 in 201f. Majority of patients(63.6%) had successful treatment outcomes. Te following predictors were signihcantly associated with MDRTB cure: presence ofcavities in chest X-rays (aOR 1.89, p value 0.002), low BMI (aOR 0.39, p value 0.0ff), and resistance to streptomycin (aOR f.46,p value 0.006) and ethambutol (aOR 0.7f, p value 0.0f1). Smoking and presence of cavities in chest X-rays were associated withMDRTB mortality, aOR 2.71, p value 0.0f7 and aOR 0.33, p value 0.019, respectively. Conclusion. Te study indicated that overallnumber of MDRTB patients and the proportion of successful treatment outcomes have been increasing over the years. Te studyrecommends improving nutritional status of MDRTB patients, widespread antismoking campaign, and close follow-up of patientswith ethambutol resistance.


Link: Tuberculosis Research and Treatment