Predictors of treatment outcome among adult patients with multi-drug resistant tuberculosis in Kano, Nigeria

Abstract

Background: Emergence of multidrug-resistant tuberculosis (MDR-TB) continues to threaten global tuberculosis (TB) treatment, care, and prevention, and it remains a major global health problem in many low- and middle-income countries with high morbidity and mortality. Objectives: The present study assessed MDR-TB treatment outcome and its predictors among adult patients in Kano, Nigeria. Methods: We conducted a secondary data analysis involving 283 adult patients treated for MDR-TB using routine data for MDR-TB programme in Kano State between August 2014 and September 2018. Results: The mean age (±standard deviation) of the respondents was 33.4 ± 11.6 years and up to 40% of them were within the age group of 25–34 years. About three-quarters of the participants 72.4% (205) were males; up to 63.6% (180) of the patients live in the urban areas, and mean duration of treatment initiation was 21 days after the diagnosis. Up to 66.8% (95% confidence interval [CI] = 61.1–72.4), patients had successful treatment, (cured) while 33.2% (95% CI = 27.6–38.9) died. After adjusting for confounding, gender and HIV status were found to be independent predictors of MDR-TB treatment outcome among MDR-TB patients in Kano. Male patients (adjusted odds ratio aOR = 0.38, 95% CI = 0.22–0.66, P = 0.001) and HIV-negative patients (aOR = 0.49, 95% CI = 0.28–0.87, P = 0.015) were less likely to die from MDR-TB. Conclusion: The study found a moderate treatment success rate for MDR-TB in Kano. Early initiation of treatment, control of HIV epidemic, and enhanced treatment supervision would likely improve treatment outcome.