ArticleBMC infectious diseases2025
Treatment outcomes of short-regimen multi-drug resistant tuberculosis in uMkhanyakude district (2018-2022) South Africa: a retrospective, cross-sectional study.
Article in BMC infectious diseases, 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
backgroundRifampicin-resistant / Multidrug-resistant tuberculosis (RR/MDR-TB), remains a major global health challenge, exacerbated by socioeconomic factors, poor treatment outcomes, and rising drug resistance. In response, RR/MDR-TB care has been decentralised to district hospitals in uMkhanyakude Health District to improve treatment access. This study aimed to assess treatment outcomes of patients receiving the nine-month short regimen for RR/MDR-TB in uMkhanyakude District from 2018 to 2022, and to identify socio-demographic and clinical factors associated with treatment success or failure.
methodsA retrospective cross-sectional study was conducted among patients aged 18 years and older who received a nine-month short-course RR/MDR-TB treatment regimen at decentralised facilities in KwaZulu-Natal's uMkhanyakude District from 2018 to 2022. Data were collected through clinical chart reviews, and descriptive statistics and multivariable regression analysis were used to identify predictors of treatment outcome.
resultsAmong 375 RR/MDR-TB patients on nine-month short-course therapy, 50.1% (n = 188) were Males. Most patients 39.5%, (n = 148) were aged 35-51 years. The treatment success rate was 81.3% (n = 305), with 48.8% (n = 183) cured and 32.5% (n = 122) completing treatment without a confirmed bacteriological cure. Unsuccessful treatment outcomes occurred in 18.7% (n = 70) of patients, including deaths 3.2% (n = 12), treatment failures 3.7% (n = 14), loss to follow-up was 6.7% (n = 25) and treatment interruption leading to unsuccessful outcomes in 5.1% (n = 19). Occupational status, treatment interruption, and adverse drug reactions (ADRs) were significant predictors of treatment failure. Employed patients had higher odds of failure (aOR = 10.5, p = 0.001). Shorter treatment interruption (1 month) was protective (OR = 0.02, p = 0.001). ADRs increased the risk of failure (OR = 4.2, p = 0.001).
conclusionThe treatment success rate for patients on the RR/MDR-TB nine-month short-course in uMkhanyakude District was high. Being employed was identified as a significant predictor of treatment failure, emphasising the need for targeted interventions for employed individuals. Further research is needed to explore Directly Observed Treatment (DOT) options for employed patients.
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