High treatment success among individuals with rifampicin-resistant tuberculosis in Botswana: A retrospective cohort study

Abstract

Background: The study reports on tuberculosis (TB) treatment outcomes among individuals diagnosed with rifampicin-resistant TB (RR-TB) and assesses predictors associated with treatment outcomes. Methods: We conducted a retrospective study to analyse treatment outcomes of 162 individuals with RR-TB from 2016 to 2023. Treatment outcome proportions were estimated using the binomial exact method with 95% confidence intervals (CI). Predictors of treatment outcomes were assessed using logistic regression models. Results: Of the 162 individuals, 102 (62.7%) were male with a median age of 39 (interquartile range (IQR): 29-50). Most individuals, 78 (48.1%), were from the Greater Gaborone health district, and 88 (54.3%) were people living with HIV (PLWH). Among these individuals, 137 (84.6%, 95% CI [78.2, 89.7]) were successfully treated. Males had higher odds of unfavourable treatment outcomes compared to females (OR = 1.70; 95% CI [0.73, 3.98]). Among those cured, a slightly higher proportion was observed among PLWH (71.8%, 95% CI [62.1, 80.3]) compared to people not living with HIV (PNLWH) (69.2%, 95% CI [58.7, 78.5]). However, the mortality rate was higher in PLWH (10.7%; 95% CI [5.5, 18.3]) compared to PNLWH (6.6%; 95% CI [2.5, 13.8]). Those with a history of TB treatment had 1.03 odds of unfavourable treatment outcomes (95% CI [0.40, 2.73]); however, this association was not statistically significant. Conclusion: Our study shows a high success rate of treatment among individuals with RR- TB, with no significant difference based on sex, TB treatment history, or HIV status. Higher mortality among PLWH highlights the need for targeted interventions among high-risk groups.