Abstract
BackgroundMultidrug-resistant tuberculosis had high treatment failure and mortality. Success rate of treatment currently 56% at global level, 48% in Indonesia and 36% in West Java province, the most populated province and surround Jakarta, the capitol of Indonesia.ObjectiveThis study aimed to evaluate factors affecting success of multidrug-resistant tuberculosis treatment in patients using longer treatment regimen in West Java Indonesia.MethodsThis was a retrospective cohort study of multidrug-resistant tuberculosis patients treated with longer regimen at Hasan Sadikin General Hospital from January 2015 to December 2017. Potential risk factors associated with the treatment outcome were analyzed using multiple logistic regression.ResultsA total of 492 patients were enrolled during the study period. Fifty percents multidrug-resistant tuberculosis patients had successful treatment outcome. Age ≤45 years, male, normal body mass index, no previous tuberculosis treatment, culture conversion ≤2 months, acid fast bacilli sputum smear ≤+1 were independent factors associated with increased treatment success. Sputum culture conversion ≤2 months was the major factor affecting successful outcome (RR 2.79; 95% CI: 1.61–4.84; p-value<0.001). Human Immunodeficiency Virus infection, chronic kidney disease, and cavitary lesion were independent risk factors for unfavourable outcome.ConclusionAge, gender, body mass index, tuberculosis treatment history, time of sputum conversion, acid fast bacilli sputum smear, HIV infection, chronic kidney disease, and cavitary lesion can be used as predictors for longer multidrug-resistant tuberculosis treatment regimen outcome.
Highlights
Multidrug-resistant tuberculosis (MDR-TB) is a condition in which Mycobacterium tuberculosis is resistant to at least isoniazid and rifampicin
This study aimed to evaluate factors affecting success of multidrug-resistant tuberculosis treatment in patients using longer treatment regimen in West Java Indonesia
Age 45 years, male, normal body mass index, no previous tuberculosis treatment, culture conversion 2 months, acid fast bacilli sputum smear +1 were independent factors associated with increased treatment success
Summary
Multidrug-resistant tuberculosis (MDR-TB) is a condition in which Mycobacterium tuberculosis is resistant to at least isoniazid and rifampicin. MDR-TB cases is increasing every year globally. There were 160,684 new cases of MDR-TB in 2017 and 186,772 new cases in 2018. MDR-TB was detected in 3.4% of new TB cases and 18% of previously treated cases [1]. The burden of MDR-TB varies among countries where India (27%), China (14%), and The Russian Federation (9%) were the top three countries contributed to the largest share of the global burden [1]. TB surveillance in the European Union or European Economic Area (EU/EEA) countries in 2014 showed that 4.0% of TB cases were MDR-TB (2.2% of all notified TB cases) as identified by the drug susceptibility testing (DST) [2]. While the prevalence of MDR-TB from TB cases undergoing DST was 1.2% in the US, 1.3% in Canada, and 2% in Australia [2]. Success rate of treatment currently 56% at global level, 48% in Indonesia and 36% in West Java province, the most populated province and surround Jakarta, the capitol of Indonesia
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