Mycobacteriology Research Center, Jimma University, P. O. Box 378, Jimma, Oromia, Ethiopia.
School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Oromia, Ethiopia.
BMC Infect Dis. 2024 Nov 14;24(1):1305. doi: 10.1186/s12879-024-10205-6.
Treatment of rifampicin-resistant or multidrug-resistant tuberculosis (RR/MDR-TB) requires the use of second-line anti-TB drugs, which are less effective and more toxic. This study assessed treatment outcomes and factors associated with unfavorable treatment outcomes among RR/MDR-TB patients in Southwestern Oromia, Ethiopia.
A multicenter retrospective study was conducted on 226 RR/MDR-TB patients (six extrapulmonary and 220 pulmonary) treated under a national TB program between 2013 and 2022 at five treatment facilities in Southwestern Oromia, Ethiopia. RR/MDR-TB patient data, such as sociodemographic, clinical, and laboratory results and treatment outcomes, were collected from the RR/MDR-TB registry using a standard data extraction form between April and June 2023. Logistic regression analysis was used to explore the associations between risk factors and unfavorable treatment outcomes.
Among 220 pulmonary RR/MDR-TB patients, 181 (82.3%) achieved favorable treatment outcomes (161 cured and 20 treatment completed). However, 39 (17.7%) patients had unfavorable treatment outcomes (12 were lost to follow-up, seven experienced treatment failure, and 20 died). Of the six extrapulmonary RR/MDR-TB patients, five (83.3%) had favorable treatment outcomes, and one (16.7%) was lost to follow-up. Pulmonary RR/MDR-TB patients with HIV infection (AOR = 4.85, 95% CI: 1.90 to 12.39), history of previous TB treatment (AOR = 3.09, 95% CI: 1.21 to 7.86), and low baseline BMI (AOR = 2.86, 95% CI: 1.06 to 7.72) had increased risk of unfavorable treatment outcomes.
Although the majority of RR/MDR-TB patients have favorable treatment outcomes, a significant proportion of patients still experienced unfavorable outcomes. Patients with HIV infection, history of previous TB treatment, and low baseline BMI require special attention to improve pulmonary RR/MDR-TB treatment outcomes. Future studies with larger sample sizes are required to evaluate treatment outcomes and associated factors among patients with extrapulmonary RR/MDR-TB.
治疗利福平耐药或耐多药结核病（RR/MDR-TB）需要使用二线抗结核药物，这些药物效果较差且毒性更大。本研究评估了在埃塞俄比亚西南部奥罗米亚地区使用二线抗结核药物治疗 RR/MDR-TB 患者的治疗结局和与不良治疗结局相关的因素。
对 2013 年至 2022 年期间在埃塞俄比亚西南部奥罗米亚地区五个治疗机构接受国家结核病项目治疗的 226 例 RR/MDR-TB 患者（6 例肺外和 220 例肺）进行了一项多中心回顾性研究。使用标准数据提取表，从 RR/MDR-TB 登记处收集 RR/MDR-TB 患者的数据，如社会人口学、临床和实验室结果以及治疗结局。采用 logistic 回归分析探讨危险因素与不良治疗结局之间的关联。
在 220 例肺 RR/MDR-TB 患者中，181 例（82.3%）获得了良好的治疗结局（161 例治愈，20 例治疗完成）。然而，39 例（17.7%）患者的治疗结局不良（12 例失访，7 例治疗失败，20 例死亡）。6 例肺外 RR/MDR-TB 患者中，5 例（83.3%）治疗结局良好，1 例（16.7%）失访。HIV 感染的肺 RR/MDR-TB 患者（AOR=4.85，95%CI：1.90 至 12.39）、有既往结核病治疗史（AOR=3.09，95%CI：1.21 至 7.86）和基线 BMI 较低（AOR=2.86，95%CI：1.06 至 7.72）的患者发生不良治疗结局的风险增加。
尽管大多数 RR/MDR-TB 患者的治疗结局良好，但仍有相当一部分患者的治疗结局不良。HIV 感染、既往结核病治疗史和基线 BMI 较低的患者需要特别关注，以改善肺 RR/MDR-TB 的治疗结局。需要进行更大样本量的研究来评估肺外 RR/MDR-TB 患者的治疗结局和相关因素。
