Survival analysis of patients with tuberculosis and risk factors for multidrug-resistant tuberculosis in Monrovia, Liberia.

Abstract

We reviewed the records of 337 confirmed cases of tuberculosis patients in Monrovia, the capital of Liberia, 2015. The risk factors affecting the survival and multidrug-resistance of tuberculosis patients were examined. Kaplan-Meier analysis and the log-rank test were used to assess the differences in survival among the patients, while Cox regression model was used for multivariate analysis. The qualitative data was tested with chi-square test in the single factor analysis of multidrug-resistant TB. Multivariate analysis was performed using binary logistic regression analysis. The significance level for all the tests were set at 0.05. The mean period of the follow-up of patients was 10 months. In the 337 patients, 33 (9.8%) died, the 21-month survival rate was 90.2%. The results of multivariate Cox regression analysis show that overcrowding (HR = 7.942, 95% CI 3.258–19.356), former smoking (HR = 3.773, 95% CI 1.601–8.889), current smoking (HR = 3.546, 95% CI 1.195–10.521), multidrug-resistance tuberculosis (HR = 4.632, 95% CI 1.913–11.217) were risk factors for death during anti-tuberculosis treatment in TB patients in Liberia. The results of binary logistic regression analysis show that extra-pulmonary (OR = 2.032, 95% CI 1.133–3.644), family history of TB (OR = 2.387, 95% CI 1.186–4.807) and current smoking (OR = 3.436, 95% CI 1.681–7.027) were risk factors for multidrug-resistant tuberculosis. These results can provide insights on local tuberculosis early intervention, increase public health awareness, and strengthen the control of factors that may affect the survival and multidrug-resistance of tuberculosis patients.