Evidence map›Paper›PMID 34376436›Full record

ArticleBMJ open2021

National treatment outcome and predictors of death and treatment failure in multidrug-resistant tuberculosis in Ethiopia: a 10-year retrospective cohort study.

Habteyes Tola, K Holakouie-Naieni, Mohammad Ali Mansournia, Mehdi Yaseri, Dinka Fikadu Gamtesa, Ephrem Tesfaye, Zemedu Mahamed, Million Molla Sisay

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

Habteyes TolaEpidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).ORCID 0000-0002-2889-956X
K Holakouie-NaieniEpidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of) holakoik@hotmail.com.
Mohammad Ali MansourniaEpidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).ORCID 0000-0003-3343-2718
Mehdi YaseriEpidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
Dinka Fikadu GamtesaTB/HIV Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Ephrem TesfayeTB/HIV Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Zemedu MahamedTB/HIV Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Million Molla SisayResearch and Evidence Generation Directorate,Saint Peter's Specialized Hospital, Addis Ababa, Ethiopia, Addis Ababa, Ethiopia.
Ethiopian Public Health Institute · ETTehran University of Medical Sciences · IR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTreatment success rate in patients treated for multidrug-resistant tuberculosis (MDR-TB) is low, but predictors of treatment failure and death have been under-reported. Thus, we aimed to determine the national proportion of treatment success rate in the past 10 years and factors that predict treatment failure and death in patients with MDR-TB in Ethiopia.

settingA retrospective cohort study with a 10-years follow-up period was conducted in 42 MDR-TB treatment-initiating centres in Ethiopia.

participantsA total of 3395 adult patients with MDR-TB who had final treatment outcome and who were treated under national TB programme were included. Data were collected from clinical charts, registration books and laboratory reports. Competing risk survival analysis model with robust standard errors (SE) was used to determine the predictors of treatment failure and death. PRIMARY AND SECONDARY OUTCOMES: Treatment outcome was a primary outcome whereas predictors of treatment failure and death were a secondary outcome.

resultsThe proportion of treatment success was 75.7%, death rate was 12.8%, treatment failure was 1.7% and lost to follow-up was 9.7%. The significant predictors of death were older age (adjusted hazard ratio (AHR)=1.03; 95% CI 1.03 to 1.05; p<0.001), HIV infection (AHR=2.0; 95% CI 1.6 to 2.4; p<0.001) and presence of any grade of anaemia (AHR=1.7; 95% CI 1.4 to 2.0; p<0.001). Unlike the predictors of death, all variables included into multivariable model were not significantly associated with treatment failure.

conclusionIn the past 10 years, although MDR-TB treatment success in Ethiopia has been consistently favourable, the proportion of patients who died is still considerable. Death could be attributed to advanced age, HIV infection and anaemia. Prospective cohort studies are necessary to further explore the potentially modifiable predictors of treatment failure.

Indexed as

HIV InfectionsTuberculosis, Multidrug-ResistantAdultAgedAntitubercular AgentsEthiopiaHumansProspective StudiesRetrospective StudiesTreatment FailureTreatment OutcomeAntitubercular Agentsepidemiologypublic healthtropical medicinetuberculosis

Identifiers

PMID34376436
PMCPMC8356165
OpenAlexW3187880548

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.