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Assessment of Factors Associated with Unfavorable Outcomes among Drug-Resistant TB Patients: A 6-Year Retrospective Study from Pakistan

Author

Listed:
  • Farman Ullah Khan

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an 710061, China)

  • Asim ur Rehman

    (Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan)

  • Faiz Ullah Khan

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an 710061, China)

  • Khezar Hayat

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an 710061, China)

  • Amjad Khan

    (Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan)

  • Nafees Ahmad

    (Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Baluchistan Quetta, Quetta 08769, Pakistan)

  • Jie Chang

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an 710061, China)

  • Usman Rashid Malik

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an 710061, China)

  • Yu Fang

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an 710061, China)

Abstract

The spread of drug-resistant tuberculosis (DR TB) poses significant challenges to the control and successful eradication of TB globally. The current retrospective study was designed to evaluate the treatment outcomes and identify the risk factors associated with unsuccessful outcomes among DR TB patients. A total of 277/308 eligible DR TB patients were enrolled for treatment at the programmatic management unit of DR TB at the Pakistan Institute of Medical Sciences, Islamabad between January 2014 and July 2019. Treatment outcomes were defined according to the WHO recommendations. Death, treatment failure, and lost to follow-up (LTFU) were collectively grouped as unsuccessful treatment outcomes, whereas cured and treatment completed were summed up together as successful treatment outcomes. Out of the total 277 patients, 265 (95.67%) were multidrug/rifampicin-resistant TB (MDR/RR-TB) cases, 8 (2.89%) were isoniazid resistant cases, and 4 (1.44%) were extensively drug-resistant ones. In the current cohort, a total of 177 (63.9%) achieved successful treatment outcomes. Among them, 153 (55.2%) were declared cured and 24 (8.7%) completed their treatment. Of the remaining 100 (36.1%) patients with unsuccessful outcomes, 60 (21.7%) died, 32 (11.5%) were LTFU, and 8 (2.9%) had failed treatment. The proportion of male patients was relatively higher (55.2%), within the age group of 21–40 years (47.3%) and lived in rural areas (66.8%). The multivariate analysis revealed that unsuccessful outcomes had a statistically significant association with being male (adjusted odds ratio, AOR: 1.92, 95% confidence interval (CI): 1.10–3.36), being in an age group above 60 years (AOR: 3.34, 95% CI: 1.09–10.1), suffering from any comorbidity (AOR: 2.69, 95% CI: 1.35–5.38), and the history of use of second-line drugs (AOR; 3.51, 95% CI 1.35–9.12). In conclusion, treatment outcomes among DR TB patients at the study site were poor and did not achieve the treatment success target (≥75%) set by the World Health Organization.

Suggested Citation

  • Farman Ullah Khan & Asim ur Rehman & Faiz Ullah Khan & Khezar Hayat & Amjad Khan & Nafees Ahmad & Jie Chang & Usman Rashid Malik & Yu Fang, 2022. "Assessment of Factors Associated with Unfavorable Outcomes among Drug-Resistant TB Patients: A 6-Year Retrospective Study from Pakistan," IJERPH, MDPI, vol. 19(3), pages 1-13, January.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:3:p:1574-:d:738554
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    References listed on IDEAS

    as
    1. Farman Ullah Khan & Faiz Ullah Khan & Khezar Hayat & Jie Chang & Muhammad Kamran & Asad Khan & Usman Rashid Malik & Asif Khan & Yu Fang, 2021. "Impact of Protracted Displacement on Delay in the Diagnosis Associated with Treatment Outcomes: A Cross-Sectional Study in Internally Displaced Tuberculosis Patients of Pakistan," IJERPH, MDPI, vol. 18(22), pages 1-14, November.
    2. Melese Yeshambaw Teferi & Ziad El-Khatib & Minyahil Tadesse Boltena & Azeb Tarekegn Andualem & Benedict Oppong Asamoah & Mulatu Biru & Hawult Taye Adane, 2021. "Tuberculosis Treatment Outcome and Predictors in Africa: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(20), pages 1-15, October.
    3. Ninfa Marlen Chaves-Torres & Santiago Fadul & Jesus Patiño & Eduardo Netto, 2021. "Factors associated with unfavorable treatment outcomes in patients with rifampicin-resistant tuberculosis in Colombia 2013–2015: A retrospective cohort study," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-10, April.
    4. Hargreaves, J.R. & Boccia, D. & Evans, C.A. & Adato, M. & Petticrew, M. & Porter, J.D., 2011. "The social determinants of tuberculosis: from evidence to action," American Journal of Public Health, American Public Health Association, vol. 101(4), pages 654-662.
    5. Ninfa Marlen Chaves Torres & Jecxy Julieth Quijano Rodríguez & Pablo Sebastián Porras Andrade & María Belen Arriaga & Eduardo Martins Netto, 2019. "Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis," PLOS ONE, Public Library of Science, vol. 14(12), pages 1-24, December.
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