Predictors for Mortality among Multidrug-Resistant Tuberculosis Patients in Tanzania.

Edson W Mollel,Jaffu O Chilongola

doi:10.1155/2017/9241238

Edson W Mollel, Jaffu O Chilongola

Open Access

https://doi.org/10.1155/2017/9241238

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Abstract

Problem Factors related to MDRTB mortality in Tanzania have not been adequately explored and reported. Objectives To determine demographic, clinical, radiographic, and laboratory factors associated with MDRTB mortality in a Tanzanian TB Referral Hospital. Methodology This was a cross-sectional study with 193 participants. Demographic, clinical, laboratory, and radiological data were collected, and their associations with mortality among MDRTB patients were determined. Results and Conclusions Cough was the commonest finding among these MDRTB patients, with 179 (92.75%) of them presenting with cough, followed by chest X-ray consolidation in 156 patients (80.83%) and history of previous TB treatment in 151 patients (78.24%). Cigarette smoking, HIV positivity, and low CD4 counts were significantly associated with MDRTB mortality, p values of 0.034, 0.044, and 0.048, respectively. Fever on the other hand was at the borderline with p value of 0.059. We conclude that cigarette smoking and HIV status are significant risk factors for mortality among MDRTB patients. HIV screening should continually be emphasized among patients and the general community for early ARTs initiation. Based on the results from our study, policy makers and public health personnel should consider addressing tobacco cessation as part of national TB control strategy.

Highlights

Multidrug-resistant tuberculosis (MDRTB), defined as resistance to both isoniazid and rifampicin, is a growing public health problem in resource-poor regions where adequate diagnosis and treatment are often unavailable
The WHO estimated 450,000 new cases of MDRTB in 2012 [1, 2]. It is a growing public health concern, with an estimation of 3.5% of new TB cases and 20.5% for those previously treated for TB to turning to MDRTB
All MDRTB patients would have to come and stay at Kibong’oto Infectious Diseases Hospital (KIDH) for intensive phase of treatment which was defined as the time from starting MDRTB treatment to 2 months after sputum culture conversion

Summary

Introduction

Multidrug-resistant tuberculosis (MDRTB), defined as resistance to both isoniazid and rifampicin, is a growing public health problem in resource-poor regions where adequate diagnosis and treatment are often unavailable. The WHO estimated 450,000 new cases of MDRTB in 2012 [1, 2]. It is a growing public health concern, with an estimation of 3.5% of new TB cases and 20.5% for those previously treated for TB to turning to MDRTB. WHO estimates that about 5% of all TB cases progress to MDRTB, of which more than 40% died in 2013 [3, 4]. There is a new regimen for treating new and uncomplicated cases of MDRTB for less than one year

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