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Tuberculosis Research and Treatment
Volume 2019, Article ID 3569018, 10 pages
https://doi.org/10.1155/2019/3569018
Research Article

Predictors of Treatment Outcomes among Multidrug Resistant Tuberculosis Patients in Tanzania

1Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
2Kibong’oto Infectious Diseases Hospital, P.O. Box 12, Sanya Juu, Tanzania
3Western Zone Blood Transfusion Center, P.O. Box 1782, Tabora, Tanzania

Correspondence should be addressed to Tamary Henry Leveri; moc.oohay@yrnehyramat

Received 1 October 2018; Revised 18 December 2018; Accepted 20 December 2018; Published 12 February 2019

Academic Editor: Isamu Sugawara

Copyright © 2019 Tamary Henry Leveri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. According to World Health Organization (WHO) the final multidrug resistant tuberculosis (MDRTB) treatment outcome is the most important direct measurement of the effectiveness of the MDRTB control program. Literature review has shown marked diversity in predictors of treatment outcomes worldwide even among the same continents. Therefore, findings could also be different in Tanzanian context, where the success rate is still lower than the WHO recommendation. This study sought to determine the predictors of treatment outcomes among MDRTB patients in Tanzania in order to improve the success rate. Methodology. This was a retrospective cohort study, which was conducted at Kibong’oto Infectious Diseases Hospital (KIDH) in Tanzania. Patients’ demographic and clinical parameters were collected from the MDRTB registry and clinical files. Then, a detailed analysis was done to determine the predictors of successful and unsuccessful MDRTB treatment outcomes. Results. Three hundred and thirty-two patients were diagnosed and put on MDRTB treatment during the year 2009 to 2014. Among them, males were 221 (67%), and 317 (95.48%) were above 18 years of age, mean age being 36.9 years. One hundred and sixty-one patients (48.5%) were living in Dar es Salaam. The number of MDRTB patients has increased from 16 in 2009 to 132 in 2014. Majority of patients (75.7%) had successful treatment outcomes. The following predictors were significantly associated with MDRTB cure: presence of cavities in chest X-rays (aOR 1.89, p value 0.002), low BMI (aOR 0.59, p value 0.044), and resistance to streptomycin (aOR 4.67, p value 0.007) and ethambutol (aOR 0.34, p value 0.041). Smoking and presence of cavities in chest X-rays were associated with MDRTB mortality, aOR 2.31, p value 0.043 and aOR 0.55, p value 0.019, respectively. Conclusion. The study indicated that overall number of MDRTB patients and the proportion of successful treatment outcomes have been increasing over the years. The study recommends improving nutritional status of MDRTB patients, widespread antismoking campaign, and close follow-up of patients with ethambutol resistance.