ArticleThe Pan African medical journal2026
Risk factors and treatment outcomes of drug-resistant tuberculosis among patients attending Ndola Teaching Hospital, Zambia: a retrospective case-control study.
Article in The Pan African medical journal, 2026. 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
Introduction: multidrug-resistant tuberculosis (MDR-TB), defined as resistance to isoniazid and rifampicin, has become a major threat to the control of TB across the globe. This study aimed to determine the risk factors and treatment outcomes of Drug-resistant tuberculosis (DR-TB) patients attending Ndola Teaching Hospital (NTH) in Ndola, Zambia. Methods: we conducted a case-control study among DR-TB patients treated at NTH from 2018 - 2020. Medical records of selected MDR-TB cases and drug susceptible TB controls were included. Treatment outcomes of MDR-TB patients were recorded. The multivariable logistic regression was used to evaluate associations between risk factors and MDR-TB infection. Odds ratios and their 95% confidence intervals were reported. Results: the mean age for the study was 36.67±9.94, and males were the majority 156 (70.9%). Those with HIV were 123 (55.9%), and contact with DR-TB patients were 61 (27.7%). A total of 110 cases and 110 controls were selected for this study. The multivariable logistic regression model indicated a strong association between a family size of 1-5 and occurrence of MDR-TB (aOR (adjusted odds ratio): 1.44, 95% CI (confidence interval), 0.74-2.79; p=0.028*). There was also a strong association between contact with TB patient and MDR-TB (aOR: 1.67, 95% CI 0.56-4.92, p=0.033*). The analysis indicated that living in the rural area had a negative association with MDR-TB development (aOR: 0.42, 95% CI 0.19-0.91, p=0.025*). There was also a negative association between history of previous treatment and developing MDR-TB (aOR: 0.32, 95% CI 0.17-0.61, p<0.001*), as well as that between contact with MDR-TB patient and MDR-TB development (aOR: 0.50, 95% CI 0.16-1.52, p=0.010*). The study further found that of the 110 MDR-TB patients treated, 73.6% had a successful treatment outcome, and 26.4% had an unsuccessful treatment outcome. Conclusion: the study found that smaller family size and contact with TB patients were significant risk factors for developing MDR-TB, while living in rural areas, having a history of previous TB treatment, and contact with MDR-TB patients were negatively associated with its occurrence. A notable proportion of unsuccessful treatment outcome of some cases underscores the need for strengthened patient-centered care, adherence support, and equitable access to healthcare across both rural and urban settings.
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