Evidence map›Paper›PMID 39965941›Full record

ArticleBMJ open2025

Determinants of unfavourable treatment outcomes of drug-resistant tuberculosis cases in Malaysia: a case-control study.

Mohd Fahmin Kamarul Zaman, Nik Rosmawati Nik Husain, Mohd Yusof Sidek, Zamzurina Abu Bakar

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

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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

4 authors.

Mohd Fahmin Kamarul ZamanDepartment of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.ORCID http://orcid.org/0009-0002-0279-971X
Nik Rosmawati Nik HusainDepartment of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia rosmawati@usm.my.ORCID http://orcid.org/0000-0002-6798-0838
Mohd Yusof SidekDepartment of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.ORCID http://orcid.org/0000-0002-4941-0428
Zamzurina Abu BakarInstitute of Respiratory Medicine, Hospital Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe emergence of drug-resistant tuberculosis (DR-TB) complicates TB management and poses significant challenges to achieve favourable treatment outcomes. Treating DR-TB is more complex and costly, requiring extended treatment durations and consideration of drug toxicity and side effects. This study aims to identify the determinants of unfavourable treatment outcomes among DR-TB patients in Malaysia.

designRetrospective case-control study.

settingSecondary data from the National Tuberculosis Registry (NTBR) across two states in Malaysia.

participantsAll reported DR-TB cases in the NTBR between 2016 and 2020 from Selangor and Wilayah Persekutuan Kuala Lumpur, Malaysia. Cases still undergoing treatment at the time of analysis were excluded. A total of 403 cases were analysed, with 181 (44.9%) experiencing unfavourable treatment outcomes and 222 (55.1%) having favourable treatment outcomes. The case group consists of individuals with DR-TB who experienced unfavourable treatment outcomes, while the control group comprises individuals with DR-TB who achieved favourable treatment outcomes. OUTCOME MEASURES: Unfavourable treatment outcomes, defined as death, treatment failure or loss to follow-up, were assessed. Predictors of these outcomes were identified through multiple logistic regression analysis.

resultsSignificant determinants of unfavourable treatment outcomes included being male (adjusted OR (aOR) 2.38, 95% CI 1.44 to 3.94), being single or divorced (aOR 1.61, 95% CI 1.03 to 2.49), having no formal education (aOR 3.09, 95% CI 1.49 to 6.41), people living with HIV (aOR 2.87, 95% CI 1.40 to 5.87) and having DR-TB categorised as rifampicin-resistant tuberculosis (aOR 3.34, 95% CI 1.90 to 5.86) or multidrug-resistant/pre-extensively drug-resistant/extensively drug-resistant-TB (aOR 2.57, 95% CI 1.52 to 4.33).

conclusionThe findings reveal a high proportion of DR-TB cases with unfavourable treatment outcomes and identify their key determinants. Targeted interventions addressing these factors are essential to improve treatment outcomes.

Indexed as

Antitubercular AgentsTuberculosis, Multidrug-ResistantAdolescentAdultCase-Control StudiesFemaleHumansMalaysiaMaleMiddle AgedRegistriesRetrospective StudiesRisk FactorsTreatment FailureTreatment OutcomeYoung AdultAntitubercular AgentsEPIDEMIOLOGYPUBLIC HEALTHRisk FactorsTuberculosis

Identifiers

PMID39965941
PMCPMC11836788

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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.