Treatment outcomes for drug-resistant tuberculosis: a retrospective longitudinal study
Abstract
Background: This study examined the treatment outcomes of multidrug-resistant tuberculosis (MDR-TB) in Kazakhstan, where its burden is notably high.
Methods: The authors conducted a retrospective longitudinal study using the National Tuberculosis Registry, this study analyzed treatment outcomes in MDR-TB patients from 2018 to 2021, and included adult patients (≥ 18 years) who completed a specific treatment. Outcomes were categorized into successful and unsuccessful treatments. Bivariate and multivariate Poisson regression models with modified errors were employed to obtain crude and adjusted risk ratios (aRR).
Results: The study cohort comprised 12,698 cases, of which 10, 306 (81.16%) completed treatment with a successful outcome, while 2,392 (18.84%) had unsuccessful outcomes. Male sex (aRR 1.35, 95% CI 1.24-1.45), urban residency (aRR 1.16, 95% 1.07-1.24), having both extrapulmonary and pulmonary tuberculosis (aRR 1.49, 95% 1.04-2.15), XDR-TB (aRR 1.31, 95% 1.08-1.59), excessive alcohol consumption (aRR 1.43, 95% 1.28-1.59), HIV-positive status (aRR 2.24, 95% 2.01-2.47), and drug abuse (aRR 1.37, 95% 1.10-1.71) significantly elevated the risk of the unsuccessful treatment.
Conclusion: Our findings underscore the need for focused strategies to reduce the MDR-TB burden, particularly among adults, male sex, relapsed cases, and XDR-TB. Despite the encouraging findings observed, further studies are necessary to update our estimates.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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