A Score to Predict the Risk of Major Adverse Drug Reactions Among Multi-Drug Resistant Tuberculosis Patients in Southern Ethiopia, 2014–2019

Figures & data

Table 1 Socio-Demographic and Behavioral Characteristics of MDR-TB Patients in Southern Ethiopia, 2014–2019 (N = 329)

Variables	Frequency (n)	Percentage (%)
Gender
Female	133	40.42
Male	196	59.58
Age
≤20	84	25.53
20–34	164	49.85
>34	81	24.62
Occupation
Government employee	23	7.0
Self-employed	94	28.57
Farmer	66	20.06
Unemployed	58	17.63
Student	81	26.74
Educational status
Illiterate	65	19.75
Primary	123	37.39
Secondary	101	30.7
Tertiary	40	12.16
Baseline smoking status
Yes	10	3.04
No	319	96.96
Baseline alcohol use
Yes	42	12.76
No	287	87.24
Baseline khat use
Yes	52	15.8
No	277	84.2

Table 2 Clinical Characteristics of MDR TB Patients in Southern Ethiopia, 2014–2019 (N = 329)

Characteristics	Frequency (n)	Percentage (%)
Type of drug regimen
Short-term regimen	65	19.76
Long-term regimen	264	80.24
Previous TB treatment
No	76	23.1
Yes	253	76.9
Site of the disease
Pulmonary	319	96.96
Extrapulmonary	10	3.04
Baseline sputum smear
Negative	90	27.35
Positive	239	72.64
Baseline culture
Negative	97	29.48
Positive	232	70.51
Baseline hemoglobin
Low	177	53.8
Normal	152	46.2
Baseline leukocyte count
Low	7	2.13
Normal	189	57.45
High	133	40.42
Model of care
Ambulatory	247	75.07
Hospitalized	82	24.93
Treatment support
Yes	274	83.28
No	55	16.72
Drug adherence
Good	277	84.19
Poor	62	15.81
Lung cavitation/infiltrations
No	83	25.23
Yes	246	74.77
Co-existence
No	289	87.84
Yes	40	12.16

Figure 1 Proportion of major adverse drug reaction/major adverse events among MDR TB patients in southern Ethiopia, 2014–219 (N = 329).

Table 3 Optimum Shrinkage Factor (Lambda) and Potential Predictors Identified by Lasso Regression by 10-Fold Cross-Validation Selection Method

ID	Description	Lambda	No. of Non-zero Coefficient.	Out-of-Sample Dev. Ratio	CV Mean Deviance
1	First lambda	0.1385441	0	0.0086	0.8921808
24	Lambda before	0.016304	6	0.1650	0.7386004
*25	Selected lambda	0.0148556	6	0.1653	0.738317
26	Lambda after	0.0135359	6	0.1650	0.7385972
29	Last lambda	0.0102394	7	0.1612	0.7419639

Note: *Lambda selected by cross-validation.

Abbreviations: Dev. ratio, deviance ratio; CV, cross-validation.

Figure 2 The cross-validation plot with minimum lambda of 0.015 and selected coefficients.

Table 4 Predictors of Major Adverse Events Identified by Lasso Regression (N = 329)

Major Adverse Events	Coef.	[95% CI]
Khat use
No	Reference (0)	Reference (0)
Yes	2.61811	[1.84, 3.40]
Drug regimen
Short term	Reference (0)	Reference (0)
Long term	1.52	[0.33, 2.70]
Model of care
Ambulatory	Reference (0)	Reference (0)
Hospitalized	0.147	[−0.64, 0.93]
Co-morbidity (co-existence)
No	Reference (0)	Reference (0)
Yes	1.84	[0.952, 2.73]
Baseline culture
Negative	Reference (0)	Reference (0)
Positive	0.64	[−0.17, 1.44]
Treatment support
No	Reference (0)	Reference (0)
Yes	−0.62	[−1.70, 0.46]

Abbreviations: Coef., coefficient; CI, confidence interval.

Figure 3 Risk score for the individualized prediction of AEs among MDR TB patients in Southern Ethiopia, 2014–2019 (N=329).

Figure 4 Receiver operating characteristic curve analysis in patients with multidrug-resistant tuberculosis in southern Ethiopia, 2014–2019 (N = 329).

Figure 5 Calibration of the score using predicted and observed probabilities of major adverse events (AEs) among patients with multidrug-resistant tuberculosis in Southern Ethiopia, 2014–2019 (N = 329).