Treatment Outcomes Of Drug Resistant Tuberculosis Patients: A Retrospective Analysis Of Data From 2012 To 2022

Abstract

Tuberculosis remains a formidable global health challenge, with drug-resistant strains posing significant hurdles in its eradication efforts. Addressing the challenge of drug-resistant and multidrug-resistant tuberculosis requires a multifaceted approach encompassing enhanced diagnostics, novel therapeutics, and patient-centered care models. This study aims to find the treatment outcomes of DR-TB patients registered at tertiary care settings along estimation of impact of associated adverse events.

This retrospective study was undertaken at a tertiary care setting of Lahore Punjab Pakistan during the year 2023. A census based data of all patients registered at programmed management of drug resistant tuberculosis site was obtained for the patients registered from 2012 to 2022. Using a predefined scheme of variables data was collected considered gender, age and occupation of patients. Treatment outcomes were measured as cured, treatment completed, treatment failure, died and defaulted from treatment. Data was presented in the form mean, frequencies and percentages. Regression analysis was applied by taking death and treatment failure as adverse outcomes excluding the treatment defaulter patients as their final fate was not known.

A total of 1438 drug resistant TB patients comprising of 49.4% males and 50.6 females with mean age of patients at the time of registration as 35.08±15.91 years were included in final analysis. A high number of 17.4% patients were died, 56.2% patients were cured and 10.4% successfully completed their treatment. Rate of loss to follow up was noted to be 11.1% and treatment failure were 4.9% in this study. Regression model showed that patients aged ≥34 years, patients having previous history of treatment and treatment strategy other than LTR are at greater risk of adverse events. Gender and comorbidities were not proven risk of adverse events among drug resistant TB patients

Overall success rate of treatment remained to be 66.6% remained far below of the target laid down by the WHO. A high mortality rate was found to be associated with drug resistant tuberculosis patients. Age ≥34 years, prior history of TB treatment and treatment strategy are risk factors for death of DR TB patients.