ArticleBMC infectious diseases2024
Factors associated with unfavorable treatment outcomes among multidrug-resistant tuberculosis patients, Sierra Leone: a cross-sectional secondary data analysis.
Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- A Retrospective Analysis Examining the Impact of Educational Attainment and Social Determinants of Health on Rifampicin-Resistant Tuberculosis Treatment Outcomes.Open forum infectious diseases · 2026Article
- Comparison of the treatment outcomes and identification of the risk factors associated with unfavorable outcomes among extra pulmonary and pulmonary tuberculosis patients under NTEP.BMC infectious diseases · 2026Article
- A Novel Clinical Nomogram for Predicting Unfavorable Tuberculosis Treatment Outcomes: A Logistic Regression Risk Model.Journal of epidemiology and global health · 2026Article
- High levels of unfavourable treatment outcomes in children with drug-sensitive TB in Sierra Leone.Public health action · 2026Article
- Beyond HIV: Prevalence and Interaction of Immunosuppressive Conditions in Patients with Tuberculosis.Annals of African medicine · 2026Observational
- Determinants of unfavourable treatment outcomes of drug-resistant tuberculosis cases in Malaysia: a case-control study.BMJ open · 2025Article
- Opinion review of drug resistant tuberculosis in West Africa: tackling the challenges for effective control.Frontiers in public health · 2024Review
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Abstract
backgroundGlobally, multidrug-resistant tuberculosis (MDR-TB) is a major public health problem. The tuberculosis rate in Sierra Leone is 298 per 100,000 people, and Sierra Leone is considered a country with a high burden of tuberculosis. In Sierra Leone, there are few studies on the outcomes of MDR-TB treatment, especially those exacerbated by COVID-19. We identified factors associated with unfavorable treatment outcomes among people with MDR-TB in Sierra Leone.
methodsWe conducted a cross-sectional study to analyze hospital-based MDR-TB data from 2017 to 2021. Demographic, clinical, and treatment outcome data were extracted from the main MDR-TB referral hospital database. We defined unfavorable outcomes as patients who died, were lost to follow-up, or defaulted. We calculated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to identify predictors of the outcomes of MDR-TB treatment.
resultsBetween 2017 and 2021, 628 people with MDR-TB were reported at Lakka Hospital; 441 (71%) were male, with a median age of 25 years (interquartile ranges: 17-34). Clinically, 21% of the 628 MDR-TB patients were HIV positive, and 413 were underweight (66%). 70% (440) of MDR-TB patients received tuberculosis treatment. The majority of patients, 457 (73%), were treated with a short treatment regimen, and 126 (20%) experienced unfavorable outcomes. Age 45 years or younger (aOR = 5.08; CI:1.87-13.82), 21-45 years (aOR = 2.22; CI:140-3.54), tuberculosis retreatment (aOR = 3.23; CI:1.82-5.73), age group, HIV status (aOR = 2.16; CI:1.33-3.53), and malnourishment status (aOR = 1.79; CI:1.12-2.86) were significantly associated with unfavorable treatment outcomes for DR-TB patients.
conclusionThis analysis revealed a high proportion of unfavorable treatment outcomes among MDR-TB patients in Sierra Leone. Malnourishment, TB retreatment, HIV coinfection, and age 45 years or younger were associated with unfavorable outcomes of MDR-TB treatment. Increasing patients' awareness, mainly among young people, heightens treatment adherence and HIV monitoring by measuring the amount of HIV in patient blood, which can reduce adverse treatment outcomes in Sierra Leone and other sub-Saharan African countries.
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