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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
Summary
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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