Predictors of treatment outcomes in drug resistant tuberculosis-observational retrospective study

Abstract

In this study, we evaluate the predictors of treatment outcomes in drug resistant tuberculosis. An observational retrospective study was conducted by using the medical records of patients confirmed for TB at Kasturba Medical College from January 2015 to December 2018. Four hundred and sixty-two TB patients were included in this study. Of the total TB-confirmed patients, about 85.1% are diagnosed with pulmonary TB (PTB) (n = 393), 11.7% were extrapulmonary tuberculosis (EPTB) (n = 54), and 3.2% (n = 15) cases had both PTB and EPTB. Among the 462 cases, the frequency of multidrug-resistant TB (MDR-TB) was 25% (n = 117), extensively drug-resistant TB was 1% (n = 3), and non-MDR cases were 74% (n = 342). The frequency of unsuccessful treatment outcome was 92.9% (n = 429) and successful outcome was 7.1% (n = 33). There were 68.2% of new and 31.8% retreatment cases of TB. HIV co-infection was found in 2.3% (n = 14) of TB cases, and among them, 64.3% (n = 9) were found in PTB cases. The major comorbidities found were diabetes (21.2%), weight loss (12.6%), and anemia (12.6%). There was a difference in rate of PTB cases across years decreasing in the year 2017, whereas ETB cases were increasing in the year 2017. The TB treatment success rate was increased from 2015 (4.8%) to 2018 (8.3%). The higher rate of poor treatment outcome emphasizes the need of improvement in TB surveillance, treatment, more stringent follow-up, monitoring, and patient education to ensure complete and successful treatment.