Our Multidrug-resistant tuberculosis poses a significant global health challenge, particularly in low- and middle-income countries where access to diagnostic and treatment services is limited. Our multi-centre retrospective cohort study attempts to evaluate treatment outcomes and predictors of death or failure among 546 multi-drug-resistant tuberculosis patients, treated at eight specialised units between January 2017 and August 2018, with follow-up until June 2020. Overall, 69% achieved successful outcomes and 22.2% died. Significant predictors of death included older age, weight <40 kg, prior vitamin D use, and delayed sputum conversion. Despite outcomes nearing World Health Organisation targets, older patients and those with prior second-line drug exposure require closer monitoring.
WHO. Third WHO consultation on the translation of tuberculosis research into global policy guidelines: meeting report, April 4, 2023. 2023. World Health Organization (WHO).
2.
BagcchiS. WHO's global tuberculosis report 2022. Lancet Microbe2023; 4: e20.
AtifMBashirAAhmadN, et al.Predictors of unsuccessful interim treatment outcomes of multidrug resistant tuberculosis patients. BMC Infect Dis2017; 17: 655.
5.
JavaidAShaheenZShafqatM, et al.Risk factors for high death and loss-to-follow-up rates among patients with multidrug-resistant tuberculosis at a programmatic management unit. Am J Infect Control2017; 45: 190–193.
6.
KurbatovaEVTaylorAGamminoVM. Predictors of poor outcomes among patients treated for multidrug-resistant tuberculosis at DOTS-plus projects. Tuberculosis (Edinb)2012; 92: 397–403.
7.
KhanMAMehreenSBasitA, et al.Predictors of poor outcomes among patients treated for multidrug-resistant tuberculosis at tertiary care hospital in Pakistan. Am Eurasian J Toxicol Sci2015; 7: 162–172.
8.
AhmadNJavaidABasitA, et al.Management and treatment outcomes of MDR-TB: results from a setting with high rates of drug resistance. Int J Tuberc Lung Dis2015; 19: 1109–1114.
9.
WahidAGhafoorAKhanAW, et al.Comparative effectiveness of individualized longer and standardized shorter regimens in the treatment of multidrug resistant tuberculosis in a high burden country. Front Pharmacol2022; 13: 973713.
10.
KhanMAMehreenSBasitA. Evaluation of treatment outcomes and factors associated with unsuccessful outcomes in multidrug resistant tuberculosis patients in Baluchistan province of Pakistan. J Infect Public Health2019; 12: 809–815.
11.
AtifMAhmadWAhmadN, et al.Treatment outcomes among multidrug-resistant TB patients in Bahawal Victoria Hospital, Bahawalpur, Pakistan: a retrospective record review. Trans R Soc Trop Med Hyg2020; 114: 733–741.
12.
Arshad JavaidNAAfridiAKBasitA, et al.Validity of time to sputum culture conversion to predict cure in patients with multidrug-resistant tuberculosis: a retrospective single-center study. Am J Trop Med Hyg2018; 98: 1629.
13.
DhedaKSheanKZumlaA, et al.Early treatment outcomes and HIV status of patients with extensively drug-resistant tuberculosis in South Africa: a retrospective cohort study. Lancet2010; 375: 1798–1807.
14.
OrensteinEWBasuSShahNS, et al.Treatment outcomes among patients with multidrug-resistant tuberculosis: systematic review and meta-analysis. Lancet Infect Dis2009; 9: 153–161.
15.
JohnstonJCShahidiNCSadatsafaviM, et al.Treatment outcomes of multidrug-resistant tuberculosis: a systematic review and meta-analysis. PLoS One2009; 4: e6914.
16.
MitnickCBayonaJPalaciosE, et al.Community-based therapy for multidrug-resistant tuberculosis in Lima, Peru. N Engl J Med2003; 348: 119–128.
17.
LeimaneVRiekstinaVHoltzTH, et al.Clinical outcome of individualized treatment of multidrug-resistant tuberculosis in Latvia: a retrospective cohort study. Lancet2005; 365: 318–326.
18.
OrmerodLP. Multidrug-resistant tuberculosis (MDR-TB): epidemiology, prevention and treatment. Br Med Bull2005; 73: 17–24.
19.
DielRNiemannS. Outcome of tuberculosis treatment in Hamburg: a survey, 1997–2001. Int J Tuberc Lung Dis2003; 7: 124–131.
20.
CoxHSKalonSAllamuratovaS, et al.Multidrug-resistant tuberculosis treatment outcomes in Karakalpakstan, Uzbekistan: treatment complexity and XDR-TB among treatment failures. PLoS One2007; 2: 1126.
21.
AnanthakrishnanRKumarKGaneshM, et al.The profile and treatment outcomes of older (aged 60 years and above) tuberculosis patients in Tamilnadu, South India. PLoS One2013; 8: e67288.
22.
TangSTanSYaoL, et al.Risk factors for poor treatment outcomes in patients with MDR-TB and XDR-TB in China: retrospective multi-center investigation. PLoS One2013; 8: e82943.
23.
ParkSLeeWLeeD, et al.Self-administered, standardized regimens for multidrug-resistant tuberculosis in South Korea. Int J Tuberc Lung Dis2004; 8: 361–368.
24.
ChiangC-YEnarsonDAYuM-C, et al.Outcome of pulmonary multidrug-resistant tuberculosis: a 6-yr follow-up study. Eur Respir J2006; 28: 980–985.
25.
MiglioriGBBesozziGGirardiE, et al.Clinical and operational value of the extensively drug-resistant tuberculosis definition. Eur Respir J2007; 30: 623–626.
26.
YewWWChanCKLeungCC, et al.Comparative roles of levofloxacin and ofloxacin in the treatment of multidrug-resistant tuberculosis: preliminary results of a retrospective study from Hong Kong. Chest2003; 124: 1476–1481.
