Predictors of unfavorable Treatment Outcome in Patients with Drug-resistant Tuberculosis in a Tertiary Care Hospital; A study from Khyber Pakhtunkhwa

Abstract

Background: Emergence of Drug-resistant tuberculosis (DR-TB) poses a great challenge to all health authorities throughout the world. DR-TB is difficult to treat due to resistance of its causative agents to anti-TB drugs. Its success rate is lower as compared to drug-susceptible TB. Objective: The objective of the present study was to determine the predictors of unfavorable treatment outcomes in patients with drug-resistant tuberculosis Methodology: This study was conducted at Lady Reading Hospital (LRH) and Hayatabad Medical Complex (HMC), Peshawar. This study included all those patients who enrolled for treatment from June 2019 to January 2021. Baseline data of all enrolled patients at LRH was collected where monthly sputum sample results were collected from HMC. Resistance to rifampicin was identified as RR-TB based on Gene-Expert analysis whereas additional resistance was found by sputum DST results. SPSS 20 was used to analyze the data. The mean ± SD was used to represent numerical data frequencies and percentages to describe categorical data, whereas the chi-square test was applied for association among different variables. P-values less than 0.005 were used as significant. Results A total of 230 DR-TB cases were included in the present study who were enrolled at the PMDT LRH during the study duration. Among them, 106 (46.0%) were men and 124 (53.91%) were women. The majority of patients 150 (65.2%) had been diagnosed with multidrug-resistant tuberculosis, which was followed by Rifampicin Resistant 60 (26.0%). There was a 158 (68.69%) cure rate and 43 patients (18.6%) died. Age and gender stratification of the result, or cure, did not show any statistically significant associations (p > 0.05). Conclusion This study has unveiled that the rate of cure for drug-resistant tuberculosis treatment regimens stands at 68.69%, while the death rate is 18.6%. Understanding the factors contributing to poor outcomes and ensuring timely diagnosis with the correct treatment protocol can enhance treatment outcomes and halt the further spread of the disease.