Predictors of Unfavorable Treatment Outcome Among Multidrug-Resistant Tuberculosis Enrollees in Osun State, Nigeria

Abstract

Background: Multidrug-Resistant Tuberculosis (MDR-TB) poses a significant challenge to Nigeria’s efforts in tuberculosis prevention and control, as well as the achievement of Sustainable Development Goal 3 (Good health and well-being). Identifying the predictors of successful MDR-TB treatment outcomes is crucial for guiding health policy implementation and containing the spread of the disease. This study aims to identify the predictors of unfavorable treatment outcomes among patients with multidrug-resistant tuberculosis in Osun State, Nigeria. Methods: This was a retrospective study that included 181 TB patients from all chest clinics in Osun state’s 30 LGAs. Data were collected using a proforma, and analysis was conducted using SPSS version 26. Univariate and bivariate analyses were performed, with the chi-square test used to determine the associations between the categorical variables. The significance level was set at 0.05. Results: Clinically, majority of the patients had pulmonary MDR-TB (181, 100.0%), were newly diagnosed with DRTB (Drug-resistant TB) (75, 41.4%), and were underweight (89, 49.2%). Regarding the laboratory profiles, nearly all the patients (92.8%) were anemic. More than four-fifths of respondents (156, 86.2%) experienced favorable treatment outcomes (cured or treatment completed), while 25 (13.8%) had unfavorable treatment outcomes. Associations were observed between drug intake (second-line drugs) and treatment outcome (p=0.001, X2=10.53), as well as hemoglobin status (p=0.045, X2=2.245). Conclusion: Successful treatment was found to be influenced by drug adherence and hemoglobin status. Therefore, there is a need to enhance adherence counseling and ensure early commencement of treatment among patients with MDR-TB.