ArticlePublic health in practice (Oxford, England)2025
Treatment outcomes of drug-resistant tuberculosis in Sabah, Malaysia - a retrospective cohort study.
Article in Public health in practice (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Addressing drug-resistant tuberculosis (DR-TB) is a priority of the tuberculosis (TB) programme. People with DR-TB frequently have worse outcomes and require more costly and complex management, compared with those with drug-sensitive TB (DS-TB). Our study examined the epidemiology of DR-TB in Sabah, Malaysia, a state with high TB burden. We aimed to identify factors associated with poor treatment outcomes. Study design: Retrospective cohort study. Methods: Data were derived from a national registry of TB patients from Sabah. Descriptive analyses were used to characterise DR-TB epidemiology, including annual trends. Multivariable logistic regression was used to identify factors associated with poor DR-TB treatment outcomes. Results: Between 2016 and 2021, there were 29,337 registered TB patients, of whom 158 (0.54 %) had DR-TB. The proportion of people with DR-TB between 2016 and 2019 was between 0.32 % and 0.47 % of annual total TB, increasing to 0.97 % in 2021. The proportion of people with DR-TB who were cured or completed treatment (63.1 %) was lower compared with DS-TB (86.0 %). In multivariable analysis, poor DR-TB treatment outcomes (death, lost to follow-up, failed treatment, transferred out & lost) were significantly associated with non-citizen status (adjusted odds ratio [aOR] = 2.49; 95 %CI 1.23-5.13) and male sex (aOR = 2.34; 95 %CI 1.15-4.94). Conclusions: There was an increase in the proportion of TB that was DR-TB, coinciding with the COVID-19 pandemic in Sabah. Non-citizens and male sex were the most significant predictors of poor treatment outcomes among those with DR-TB.
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