Predictors of mortality among drug-resistant tuberculosis patients in Kaduna State, Nigeria.

Abstract

Specific death due to DR-TB has significantly contributed to tuberculosis (TB) mortality and overall global deaths. This study examines the predictors of mortality among DR-TB patients in Kaduna State, Nigeria. This was a retrospective longitudinal study of DR-TB mortality carried out among 370 DR-TB patients from the 23 LGAs in Kaduna State. It involves a retrospective review of the MDR-TB records of the patients over a period of 10 years (2012-2021). Demographic and clinical data of all DR-TB patients enrolled in Kaduna State, Nigeria, between April 1, 2012, and March 31, 2021, were used. Survival analysis was performed with SPSS version 25, using Kaplan-Meier and Cox proportional hazard regression modeling, at 5% significance level. The majority of the patients, 255 (68.9%), were below the age of 40 years, while 53 (14.3%) of the patients died within the study period. Most deaths 26 (49.1%) were associated with HIV co-infection and the disease severity. Results for the Cox proportional model show that there was a significantly lower risk of death when a patient had MDR-TB compared to pre-XDR-TB (adjusted hazard ratio, AHR = 0.34, 95% CI = 0.16-0.72, P = 0.04). Both models show that age, sex, residence, or year of treatment had no significant association with survival or death. HIV co-infection and DRTB with progression to more resistant and difficult-to-treat strains contributed to higher deaths. There is a need for concerted efforts from all DR-TB stakeholders to control the disease.