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Determinants of treatment outcomes in patients with multidrug-resistant TB

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BACKGROUND: Treating multidrug-resistant TB (MDR-TB) remains challenging. However, the determinants and timing of poor outcomes during MDR-TB treatment are still poorly understood.

METHODS: We conducted a retrospective cohort study on all adult MDR-TB patients treated at Persahabatan Hospital, Jakarta, Indonesia, between January 2013 and December 2016. Risk factors for poor outcomes were analysed using Cox regression.

RESULTS: Death occurred at a median time of 6 months (IQR 4–14) and loss to follow-up (LTFU) at 7 months (IQR 3–11). In multivariate analysis, advanced age (aHR 2.91, 95% CI 1.21–6.96; P = 0.017 for age >60 years), having diabetes mellitus (aHR 2.18, 95% CI 1.25–3.82; P = 0.006) and HIV co-infection (aHR 3.73, 95% CI 1.14–12.23; P = 0.030) were predictive of poor outcome in the first 7 months of treatment, whereas history of LTFU (patients who were LTFU once: aHR 2.14, 95% CI 1.33–3.47; P = 0.002; patients who were LTFU more than once: aHR 3.61, 95% CI 1.68–7.77; P = 0.001) and baseline body mass index <18.5 kg/m2 (aHR 1.98, 95% CI 1.10–3.56; P = 0.022) predicted poor outcome after 7 months of treatment.

CONCLUSION: Different subsets of patients with MDR-TB are at risk of poor outcome at different times during treatment.

Keywords: HIV infection; diabetes mellitus; loss to follow-up; medication adherence

Document Type: Research Article

Affiliations: 1: Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia, Lung Clinic, Persahabatan Hospital, Jakarta, Indonesia 2: Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

Publication date: February 1, 2022

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

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