The purpose of this study was to examine factors associated with treatment outcome of multidrug-resistant tuberculosis (MDR-TB) cases in Nepal. A retrospective analysis of MDR-TB cases by demographic determinants and treatment was conducted. A total of 494 MDR-TB cases were registered from 2005 to 2008, with data obtained from the National Tuberculosis Center. Chi-squared tests were used to assess statistically the association between smear and culture conversion and treatment outcome. Determinants were analyzed with the use of Kaplan–Meier curves and Cox proportional hazards models to generate estimates of the associations with the time to treatment outcome. Sputum conversion status and culture conversion status were positively associated with treatment outcome for MDR-TB. In a multiple Cox proportional hazards regression model, no determinants were found to be associated with time to cure.
World Health Organization. Global Tuberculosis Control: Surveillance, Planning, Financing. Geneva, Switzerland: World Health Organization; 2008.
2.
World Health Organization. Tuberculosis Control in South East Asia Region. Geneva, Switzerland: World Health Organization; 2009.
3.
EspinalMALasersonKCamachoM. Determinants of drug resistant tuberculosis: analysis of 11 countries. Int J Tuberc Lung Dis. 2001;5:887-893.
4.
JanakanNSeneviratneR. Factors contributing to medication noncompliance of newly diagnosed smear-positive pulmonary tuberculosis patients in the district of Colombo, Sri Lanka. Asia Pac J Public Health. 2008;20:214-223.
5.
National Tuberculosis Center. National Tuberculosis Control Programme: Annual Report. Bhaktapur, Nepal: Ministry of Population and Health, Government of Nepal; 2008.
6.
Department of Health Services. Annual Report (2066-67). Katmandu, Nepal: Ministry of Population and Health, Government of Nepal; 2008.
7.
StewartDE. Human rights issues and health practices. Asia Pac J Public Health. 1998;10:94-99.
8.
WrightAZignolMVan DeunA. Epidemiology of antituberculosis drug resistance 2002-07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance. Lancet. 2009;373:1861-1873
9.
BamDSMallaPShresthaB. Utilisation of national MDR-TB surveillance data to illuminate sources of MDR TB. Int J Tuberc Lung Dis. 2004;8(11suppl 1):S47.
10.
HurtigAKPandeSBPorterJDBamDS. Tuberculosis treatment and private practitioners, Kathmandu Valley. J Nepal Med Assoc. 2000;39:163-168.
MallaPKanitzEEAkhtarM. Ambulatory-based standardized therapy for multi-drug resistant tuberculosis: experience from Nepal, 2005-2006. PLoS One. 2009;4:e8313.
13.
HadiartoMTjandraYAHudoyoA. Treatment of multidrug-resistant tuberculosis in Indonesia. Chemotherapy. 1996;42(suppl 3):24-29.
14.
SuoJYuMCLeeCNChiangCYLinTP. Treatment of multidrug-resistant tuberculosis in Taiwan. Chemotherapy. 1996;42(suppl 3):20-23.
15.
YewWWChanCKChauCH. Outcomes of patients with multidrug-resistant pulmonary tuberculosis treated with ofloxacin/levofloxacin-containing regimens. Chest. 2000;117:744-751.
16.
ParkSKKimCTSongSD. Outcome of chemotherapy in 107 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. Int J Tuberc Lung Dis. 1998;2:877-884.
17.
TahaogluKTörünTSevimT. The treatment of multidrug-resistant tuberculosis in Turkey. N Engl J Med. 2001;345:170-174.
18.
VenablesWNSmithDM; R Development Core Team. An Introduction to R: Notes on R: A Programming Environment for Data Analysis and Graphics (Version 2.6.2). R Development Core Team; 2004.
19.
AvendanoMGoldsteinRS. Multidrug-resistant tuberculosis: long term follow-up of 40 non-HIV-infected patients. Can Respir J. 2000;7:383-389.
20.
Flament-SaillourMRobertJJarlierVGrossetJ. Outcome of multidrug-resistant tuberculosis in France: a nationwide case-control study. Am J Respir Crit Care Med. 1999;160:587-593.
21.
BalasubramanianRGargRSanthaT. Gender disparities in tuberculosis: report from a rural DOTS programme in south India. Int J Tuberc Lung Dis. 2004;8:323-332.
22.
Jimenez-CoronaMEGarcia-GarciaLDeriemerK. Gender differentials of pulmonary tuberculosis transmission and reactivation in an endemic area. Thorax. 2006;61:348-353.
23.
HoltzTHSternbergMKammererS. Time to sputum culture conversion in multidrug-resistant tuberculosis: predictors and relationship to treatment outcome. Ann Intern Med. 2006;144:650-659.
24.
MirsaeidiSMTabarsiPKhoshnoodK. Treatment of multiple drug-resistant tuberculosis (MDR-TB) in Iran. Int J Infect Dis. 2005;9:317-322.
25.
MukherjeeJSRichMLSocciAR. Programmes and principles for management of multidrug-resistant tuberculosis. Lancet. 2004;372:474-481.
