Abstract

The extent and burden of MDR-TB varies significantly from country to country. In Africa, fewer than half of patients receiving therapy for multidrug-resistant TB (MDR TB) are successfully treated. Even though MDR-TB treatment was started in 2009 survival of MDR-TB treatment particularly of adverse treatment outcome is not studied in national level. Institution based retrospective cohort study was conducted at randomly selected four treatment Initiative Centers (TIC) & referral hospitals in Ethiopia. Data was collected using standardized checklist by trained professionals through reviewing records of all patients ever enrolled. Cox- proportional hazard regression model was built of the 494 records reviewed, 462 met the inclusion criteria. These patients were followed for 202250 person-day of observation; during the follow up period 38 (8.2%) patients were died making overall incidence density rate of 6.79 (95% CI=5.42-8.78) per 100 Person year. Survival at the end of 1st and 4th month was 98.2% and 92.3% respectively, while the overall mean survival time was 24.82(95%CI=22.8-25.72) months. Drugs side effect 3 (95 % CI [2.5-4.3, medical diagnosis other than TB 3.3 (95 % CI [1.7-5.6], HIV sero-status 2.7 (95 % CI [3.4-9.11] and bigger base line body were independently and significantly predicted mortality of MDR-TB patients. The incidence of death and treatment outcomes was in acceptable ranges, yet it needs due attention. Intervention to further reduce deaths has to focus on patients with co-morbidities, HIV, adverse effect and smaller base line body weight. Key words: 'MDR-TB, Survivable, Mortality, Ethiopia.

Highlights

  • Tuberculosis (TB) remains the largest infectious disease killers worldwide

  • This study aimed at assessing the survival status and identifies predictors of mortality from multidrug resistant tuberculosis (MDR-TB) among patients treated in TB referral hospitals/treatment initiation centers (TIC) in Ethiopia

  • 462 records with full information on treatment outcome and its date were included in the study from the selected MDRTB referral hospitals and treatment initiation centers in Ethiopia

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Summary

Introduction

Tuberculosis (TB) remains the largest infectious disease killers worldwide. Multidrug-resistant tuberculosis (MDR-TB) is a type of TB that is resistant to at least the first line anti-TB drugs (Rifampicin and Isoniazid) (WHO, 2011). The increasing incidence of MDR-TB and extensively drugresistant (XDR-TB) tuberculosis is a major concern for TB. Control programs worldwide (Zignol et al 2012). Drugresistant TB is a man-made problem, largely being the consequence of human error as a result of individual or combination of factors related to management of drug supply, patient management, prescription of chemotherapy, and patient adherence. Poor infection control practice has been identified as a major contributing factor for the spread of MDR-TB. MDR-TB, like drug susceptible TB, is a droplet infection and is transmitted to immune compromised individuals, especially to the HIV infected (FMOH, 2009)

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