Treatment Outcome and Its Determinants among Multi drug resistant Tuberculosis patients in Addis Ababa, Ethiopia.

Abstract

Introduction: Multi drug resistant tuberculosis is a worldwide challenge at this time, affecting the whole effort towards the control of tuberculosis. It can be due to primary acquisition or may develop during the course of treatment. So in order to succeed in the control and prevention of tuberculosis and multi drug resistant tuberculosis (MDR-TB), it is necessary to disclose the challenges of quality MDR-TB management, and then to succeed over the tuberculosis elimination. Objective: The objective of this study is to assess the treatment outcome and determinant among MDR-TB patients in St. Peter Specialized Hospital, AA, Ethiopia. Methods and Materials: Retrospective cohort study was used(retrospective cross-sectional cohort). All patients records from February 29/2009 to march 30/2015 were included in this study. Result:277(42%) of the patients were females, and 367(56.9%) of them were HIV positive. The treatment success rate was 77.8% and 22.2% of them have unfavorable outcome. Among these 68.7% was treatment completed,8.9% were cured and 13.6% were died. The rest was 0.6% were failure, and 8.06% lost to follow-up. Unfavorable outcome 1.96 times higher 95%CI: 1.1-3.6 and p value of 0.026 among HIV positives. Also those with history of cardiac disease were 5.6 times higher to end with unfavorable outcome 95% CI of 1.11-28.6 and p value of 0.037. Presence of base line bronchioectasis AOR of 2.1,95% CI of 1.04-5.10 and p value of .049, presence of base line opacity on chest X-RAY (AOR = 7.8, 95% CI:1.29-48.6, P= 0.001) and effusion AOR 1.96 and 95%CI1.1-3.7 and p value 0.033. having diarrheal disease as a side effect (AOR = 2.26, 95% CI:1.05-4.8, P= 0.018), Psychosis during treatment (AOR = 2.56, 95% CI of 1.2-5.4 P= 0.028). Conclusion: This has study shown the treatment was outcome good as compared to most of the other studies. Again the treatment failure is very low that the treatment quality looks good. xi However the treatment default or lost to follow up rate was seen to be raised slightly. Again the patents with unknown treatment outcome were also seen. Complicated MDR-TB at base line and some super imposed infection HIV and cardiac diseases and some side effects like diarrhea, Nephrotoxicity and psychosis looks to end with unfavorable outcome