Multi-Drug Resistant Tuberculosis Treatment Outcomes and Associated Factors in Bule Hora General Hospital, Southern Ethiopia: Cross Sectional Study

Abstract

Background: Drug-resistant TB continues to be a public health threat. In Ethiopia even though MDR-TB treatment in ambulatory set up like Bule Hora General Hospital was started in 2014, the treatment outcome was not assessed in many centers. Objective: To assess the Multidrug resistant tuberculosis (MDR-TB) patient treatment outcomes and associated factors at Bule Hora General Hospital, south Ethiopia. Methods: Facility based retrospective cross-sectional study was conducted at Bule Hora General Hospital involving patients treated during a period of 01 January 2014 to 31 December 2021. Summary statistics such as frequency, mean and percentage were computed and odds ratio calculated. Univariate and multivariate logistic regression were conducted to determine factors associated with poor drug resistant tuberculosis treatment outcomes Result: Total of 128 participants were involved in the study; the mean age was 34.95 years (±15). Almost half of them, 63 (49.2%) had prior history of TB treatment, and 25 patients (19.5%) had history of drug interruption. Thirty-nine (30.5%) had HIV infection. Drug sensitivity test revealed 3 (2.3%) participants had resistance to rifampicin (RIF), isoniazid (INH), ethambutol (EMB), and streptomycin(SM). All patients received standardized regimens (long- and short-terms standardized regimens), and 74 (57.8%) patients experienced drug adverse effects. Ninety-one (71.1%) participants had favourable outcome defined as cured, 59 (46.09%) and treatment completed, 32 (25%). HIV co- infection (aOR 0.410, 95% CI 0.177-0.973), presence of comorbid medical conditions (aOR 0.206, 95% CI 0.067-0.632), and poor treatment adherence (aOR 0.367 (0.016-8.344) were associated with unfavourable treatment outcome. Conclusion: The new ambulatory program to manage MDR TB in Bule Hora showed a favourable outcome (71.1%). The outcome of MDR-TB treatment was poor in patients with HIV seropositivity, comorbidities, and a history of drug discontinuation. So this ambulatory program needs to be expanded more in Ethiopia to reduce delay of treatment and patient overload in limited centres.