Socioepidemiological status and clinical outcome of MDR TB patients in a tertiary medical college in Southern Odisha

Abstract

Introduction: India accounts for one-fourth of the global TB burden. The load of drug-resistant TB is of foremost attention and concern at international, regional, and national levels. As per estimates of TB burden in India in 2018, the MDR/RR-TB incidence was 1.30 lakhs. Objectives: Socioepidemiological status and clinical outcome of MDR TB patients in a teaching hospital in tribal area of southern Odisha from 2012-2020. Material and Methods: This is a retrospective observational study accepted by the Institutional Ethics Committee of this tertiary medical college & hospital to which the DRTB centre is attached with the agreement of the program administrators. Inclusion Criteria: Patients with >15 years of age, those patients with pulmonary and extrapulmonary tuberculosis with normal liver enzymes. Exclusion Criteria: Patients having abnormal liver enzymes before treatment, pregnant ladies and children <15 years of age. Results: A total of 40 MDR TB patients were included. The patients’ mean age was 36.65 ± 11.75 years. 65% of the patients had BMI below 18.5 kg/m 2 . 17.5% of patients had comorbidities. Approximately 45% had successful treatment outcomes. Poor treatment outcome includes loss to follow-up in 22.5% and mortality in 12.5%. We did not find any treatment failure. Conclusion: Treatment success outcomes occurred in less than half of the cases. The main predictors of mortality among MDR-TB patients were the presence of comorbidities like anaemia, baseline leucocytosis or lymphopenia, hypoproteinaemia, HIV sero-positivity and smaller baseline BMI.

Community-based directly observed therapy is effective and results in better treatment outcomes for patients with multi-drug resistant tuberculosis in Uganda

“…These social factors were not signi cantly associated with successful treatment in this study and could be explained by the fact that Uganda NTLP implements an enabler program that provides all DR TB patients with dry rations and transport vouchers to facilitate monthly visits to tertiary hospitals for treatment monitoring, preventing their households from experiencing catastrophic costs(36). Comorbidities, including HIV, diabetes, and hypertension have been documented to contribute to poor treatment outcomes among DR-TB patients (37)(38)(39). Despite the fact that those infected with HIV showed a tendency towards poorer outcomes, our study did not nd underlying comorbidities to be statistically signi cantly associated with treatment success.…”

Predictors for Mortality in Multidrug Resistant Pulmonary Tuberculosis Patients in a South Indian Region

“…Type 2 diabetes, anemia was noteworthy among the patients similar to one another study. 27 The combination of metabolic disorders, hyperglycemia and bacterial genetics impair the functions of phagocytosis, chemotaxis and inflammatory mediators. 28 This results in unfavorable treatment outcomes and at risk of failure in therapy, relapse and has an association in development of MDRPTB, mortality.…”