Assessment of Factors Associated with Unfavorable Outcomes among Drug-Resistant TB Patients: A 6-Year Retrospective Study from Pakistan

Farman Ullah Khan, Asim ur Rehman, Faiz Ullah Khan, Khezar Hayat, Amjad Khan, Nafees Ahmad, Jie Chang, Usman Rashid Malik and Yu Fang
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Farman Ullah Khan: Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
Asim ur Rehman: Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
Faiz Ullah Khan: Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
Khezar Hayat: Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
Amjad Khan: Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
Nafees Ahmad: Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Baluchistan Quetta, Quetta 08769, Pakistan
Jie Chang: Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
Usman Rashid Malik: Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
Yu Fang: Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China

IJERPH, 2022, vol. 19, issue 3, 1-13

Abstract: The spread of drug-resistant tuberculosis (DR TB) poses significant challenges to the control and successful eradication of TB globally. The current retrospective study was designed to evaluate the treatment outcomes and identify the risk factors associated with unsuccessful outcomes among DR TB patients. A total of 277/308 eligible DR TB patients were enrolled for treatment at the programmatic management unit of DR TB at the Pakistan Institute of Medical Sciences, Islamabad between January 2014 and July 2019. Treatment outcomes were defined according to the WHO recommendations. Death, treatment failure, and lost to follow-up (LTFU) were collectively grouped as unsuccessful treatment outcomes, whereas cured and treatment completed were summed up together as successful treatment outcomes. Out of the total 277 patients, 265 (95.67%) were multidrug/rifampicin-resistant TB (MDR/RR-TB) cases, 8 (2.89%) were isoniazid resistant cases, and 4 (1.44%) were extensively drug-resistant ones. In the current cohort, a total of 177 (63.9%) achieved successful treatment outcomes. Among them, 153 (55.2%) were declared cured and 24 (8.7%) completed their treatment. Of the remaining 100 (36.1%) patients with unsuccessful outcomes, 60 (21.7%) died, 32 (11.5%) were LTFU, and 8 (2.9%) had failed treatment. The proportion of male patients was relatively higher (55.2%), within the age group of 21–40 years (47.3%) and lived in rural areas (66.8%). The multivariate analysis revealed that unsuccessful outcomes had a statistically significant association with being male (adjusted odds ratio, AOR: 1.92, 95% confidence interval (CI): 1.10–3.36), being in an age group above 60 years (AOR: 3.34, 95% CI: 1.09–10.1), suffering from any comorbidity (AOR: 2.69, 95% CI: 1.35–5.38), and the history of use of second-line drugs (AOR; 3.51, 95% CI 1.35–9.12). In conclusion, treatment outcomes among DR TB patients at the study site were poor and did not achieve the treatment success target (≥75%) set by the World Health Organization.

Keywords: drug-resistant tuberculosis; antibiotics; epidemiology; factors; treatment success (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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