Treatment Outcome of MDR/RR TB in a Resource-Constrained Setup: A Four-Year Retrospective Analysis

Figures & data

Table 1 Socio Demographic Characteristics of MDR/RR-TB Patient Who Were on Treatment in Dilchora Hospital, Dire Dawa City Administration, Eastern Ethiopia (n = 146)

Variables	Frequency	Percentage%
Age (years)
14–29	87	59.6
30–44	34	23.3
45–59	23	15.8
≥60	2	1.4
Sex
male	87	59.6
Female	59	40.4

Table 2 Baseline Clinical Characteristics of MDR/RR-TB Patients in Dilchora Hospital, Dire Dawa, Eastern Ethiopia (n = 146)

Variables	Frequency	Percentage%
HIV status of the patients
Positive	26	17.8
On HAART	24	92.3%
Not on HAART	2	7.7%
Negative	120	82.2
Presence of comorbidity
None	108	74
COPD	24	16.4
DM	9	6.1
HTN	2	1.4
Others	3	2.1
Anthropometric measurement (BMI)
BMI	Mean =17Kg/m^2±3.2
< 18.5 kg/m^2	109	74.7
18.5–25 kg/m^2	34	23.3
>25 kg/m^2	3	2.1
History of previous TB treatment
New	26	17.8
Treated with first line	115	78.8
Treated with second line	5	3.4
History of treatment interruption
Yes	49	33.6
No	96	65.8
Delay of treatment initiation
<2 month	111	77.6
≥2 months	32	22.4

Table 3 Laboratory Characteristics of MDR/RR-TB Patients in Dilchora Hospital, Dire Dawa, Eastern Ethiopia (n = 146)

Variables	Frequency	Percentage%
Hemoglobin
<12	91	62.3
≥12	55	37.7
Baseline serum creatinine
<1.2	138	94.5
≥1.2	8	5.5
Smear grading at base line
+ 3 smear	32	21.9
+2 smear	37	25.3
+1 smear	39	26.7
Scanty	21	14.4
Negative	17	11.7
Baseline DST result
RIF resistance only	76	52.1
Resistance to RIF, INH	63	43.2
Resistance to RIF, INH, EMB, SM	7	4.8
Radiological (x-ray) pattern of lung lesion
Cavitary lesion	58	39.7
Consolidative	28	19.2
Reticulonodular	24	16.4
None	36	24.7
Radiological extent of lung lesion
Unilateral	51	34.9
Bilateral	59	40.4
None	36	24.7

Table 4 MDR/RR-TB and Treatment-Related Characteristics of MDR-TB Patients in Dilchora Hospital, Dire Dawa, Eastern Ethiopia (n = 146)

Site of MDR-TB
Pulmonary	145	99.3
Extra pulmonary TB	1	0.7
Treatment regimens
Standard regimens	142	97.3
Individualized regimens	4	2.7
Month of first culture conversion	Median= 2 month
<2 month	46	31.7
2 month	55	37.9
>2 month	44	30.4
Adverse drug reaction of treatment
Yes	130	89.0
No	16	11.0
Type of adverse drug reaction
Hepatitis (jaundice)	3	2.3
GI upset	101	77.7
Renal toxicity	7	5.4
Psychiatric illness	8	6.2
Ototoxicity	3	2.3
Severe hypokalemia	6	4.6
Others	2	1.5

Figure 1 Magnitude of treatment outcome of MDR/RR-TB patients who were on treatment in Dilchora Hospital, Dire Dawa city administration, Eastern Ethiopia (n = 146), 2014–2018.

Table 5 Bi-Variate Analysis of Variables for MDR/RR-TB Patients in Dilchora Hospital, Dire Dawa, Eastern Ethiopia (n = 140)

Variable	Category	Frequency	COR	P-value
Sex	Male	84	1	0.902
	Female	56	1.078
AGE (years)	<35	96	1	0.045
	≥35	44	3.443
BMI (kg/m^2) *	-	-	0.643	0.009
Hemoglobin (g/dl) *	-	-	0.877	0.057
Baseline creatinine	<1.2	132	1	0.111
	≥1.2	8	4.067
Anti-TB exposure	No exposure	26	1	0.358
	Exposed	114	2.67
HIV status	Negative	114	1	0.001
	Positive	26	8.032
Comorbidity other than HIV	Yes	37	3.129	0.063
	No	103	1
Drug sensitivity test	Rif only resistance	76	1	0.363
	Rifampicin+ at least 1 other	64	1.744
Radiologic pattern	Cavitary	58	1	0.53
	Non cavitary	82	0.684
Treatment delay	<60 days	108	1	0.288
	≥60 days	29	2.00
Time till culture conversion*	-	-	1.711	0.018
Presence of ADR	Yes	125	1.351	0.781
	No	15	1

Notes: *Continuous variable – category doesn’t apply. Bold text – P-value <0.25.

Table 6 Multi –Variable Model Showing Significantly Associated Variables

Variable	Category	Frequency	AOR	95% CI	P-value
Age	<35	85	1	-	0.158
	≥35	44	3.324	0.63–17.58
Hemoglobin*	-	-	1.007	0.81–1.25	0.952
Creatinine	<1.2	122	1	-	0.164
	≥1.2	7	5.765	0.49–68.07
HIV	Negative	103	1	-	0.035
	Positive	26	6.466	1.14–36.68
Comorbidity	Yes	37	1.991	0.33–12.04	0.453
	No	92	1	-
BMI*	-	-	0.647	0.44–0.95	0.025
Time till culture conversion*	-	-	2.241	1.08–4.66	0.031

Notes: *Continuous variable – category doesn’t apply. Bold text – P-value <0.05.