INCIDENCE AND PREDICTORS OF POOR TREATMENT OUTCOME AMONG MULTI DRUG RESISTANCE TUBERCULOSIS PATIENTS IN TREATMENT INITIATION CENTERS OF SNNPR, ETHIOPIA.

Abstract

ackground: Multi-drug resistant tuberculosis is the major concern at global, regional and country levels. Treatment of drug-resistant tuberculosis is highly complex. It takes longer treatment time, toxic, Costly and poor treatment outcomes including death or treatment failure. Incidence and predictors of poor treatment outcome among multi-drug resistance patients were not addressed in southern Ethiopia previously. Therefore, this study tried to assess incidence and predictors of poor treatment outcome among multi-drug resistance tuberculosis patients in three TICs of SNNPR. Objectives: To assess incidence of poor treatment outcome and its predictors among multi-drug resistant tuberculosis patients in Treatment initiation centers of south Ethiopia. Methods: Hospital based retrospective cohort study conducted from September 1, 2014 to August 30, 2020. All drug-resistance tuberculosis patients registered in Arba Minch general hospital, Queen Eleni memorial hospital and Butajira general hospital were included.267 patient charts were eligible and included in this study. Data collected from April 20 to May 10, 2021. Data entered to epi Data version 4.6 then exported and analyzed using STATA 14.1. Kaplan Meier curve and Log-rank test used to estimate survival time and to compare the survival experience between groups. Multicolinerity effect and PH assumption checked. Bivariable and multivariable Cox proportional hazards model were fitted. Variables having a p-value <0.05 at 95% CI in multivariable analysis were considered as statistically significant. Result: The incidence rate of poor treatment was 10.14. Predictors of time to poor treatment outcomes were malnutrition AHR=7.15 (95% CI; 3.32, 15.4), interruption of drugs AHR=3.65 (95% CI; 1.64, 8.1), drug adverse effect AHR=6.8 (95% CI; 3.14, 15.6), smoking cigarette AHR=2.7 (95% CI; 1.2, 6.1) and khat use AHR=8.5) (95% CI; 2.13, 33.8). Conclusion and Recommendations: incidence rate of poor treatment outcome was 10.14 and it is comparable with many other study findings. Malnutrition, drug side effect, interruption of MDR TB treatments, smoking and khat use were independent predictors of time to poor treatment outcome. Therefore, integrated TB/HIV programs should focus on the factors identified to decrease incidence rate of poor treatment outcome of multi drug resistant tuberculosis patients.