Assessment of treatment outcome and associated factors among mdr-tb patients in dire dawa administration at dilchora hospital, eastern Ethiopia

Abstract

Background: The emergence of drug resistance tuberculosis, particularly MDR-TB has become a major public health problem in a number of countries and an obstacle to the global TB control efforts. Information on treatment outcomes among patient with multi drug resistant tuberculosis (MDR-TB) were limited and the new outpatient program to manage MDR TB was introduced in Dire Dawa Ethiopia. Objective: The study was carried out to assess the treatment outcome and associated factors of MDR-TB patients in Dire Dawa administration Dilchora Hospital Treatment Initiation Center. Methods: The study design was descriptive retrospective one reviewing medical records, radiological reports and bacteriological reports of MDR-TB of 146 MDR-TB patients since January 2013 to December 2017. Frequency, mean and percentage were computed for descriptive analysis. Bivariate and multivariate analysis was conducted for inferential statics. Result: Mean age of study participants was 30 years (30 ±12SD). Most of them (82%) had prior history of TB treatment, and 49 patients (33.6%) had history of drug interruption. 26 (17.8%) had HIV infection. Drug sensitivity test revealed 7 (4.8%) resistance to RIF,INH,EMB, and SM. Most common radiologic finding was cavitary lesion, but 25% of patients revealed normal finding. 97% of the patients received standardized regiment, and 130 patients experienced drug side effect. 128(87.7%) of the study participants had favorable outcome (cured /72.6%) and treatment completed /15.1%)). In logistic regression, HIV co- infection and those who had at least one social and/ or behavioral risk factors were associated with unfavorable treatment outcome. Conclusion and recommendation: The new outpatient program to manage MDR TB in Dire Dawa showed a favorable outcome. The outcome of MDR-TB treatment was poor in patients with HIV seropositive and those who had at least one social and/ or behavioral risk factor. HIV screening should be reemphasized among TB patients for early initiation of ARTs. In order to prove the association between the outcome of MDR TB treatment and socio-behavioral risk factors, larger scaled researches may be needed.