2025/03/17 by Gezae, Kebede Embaye, Berhie, Kidanemariam Alem, Gebretsadik, Letekirstos Gebreegziabher +1
paper · doi:10.71624/fj09np10
Background: Ethiopia has set remarkable targets to eliminate tuberculosis (TB) by 2050, yet the coverage for drug-resistant TB (DR-TB) remains alarmingly low at 25%. This study focuses on Tigray, where robust and comparable data on DR-TB are scarce. It aims to investigate incidence and predictors of poor treatment outcomes of DR-TB in Tigray from 2014 to 2019. Methods: A multi-center hospital-based retrospective cohort study was conducted across four Treatment Initiating Centers (TICs) in three zones of Tigray which included 249 DR-TB patients. Data were extracted from DR-TB registers between April 15 and July 30, 2020. DR-TB Treatment outcomes were categorized as poor (death, lost to follow-up, or treatment failure) or good (cured or treatment completion). The study used Cox regression to identify predictors of time to poor treatment outcomes, reporting adjusted hazard ratios (AHR) and 95% confidence intervals (CI). Results: Over 4255.2 person-months, with a median follow-up of 19.9 months (IQR: 12.0-22.0), the median time to poor treatment outcome was 7.3 months (IQR: 3.4-12.6). Poor treatment outcomes were observed in 24.9% of patients, translating to an incidence rate of 14.6 per 1000 person-months. Significant predictors of poor outcomes included prior treatment with second-line anti-TB drugs (AHR=2.80; 95% CI: 1.10-7.15) and HIV co-infection (AHR=3.00; 95% CI: 1.81-4.99). Patients previously treated with second-line drugs and those co-infected with HIV faced significantly elevated risks. Conclusion: The findings underscore substantial challenges in managing DR-TB in Tigray, with a high proportion of patients experienced adverse outcomes. Addressing the complexities of DR-TB in Tigray demands sustained efforts and tailored strategies. Enhancing treatment protocols for previously treated cases and strengthening TB-HIV collaborative services are crucial steps toward improving outcomes in DR-TB management. The study further advocates for targeted interventions focusing on recurrent TB cases and integrated TB-HIV services to enhance DR-TB treatment outcomes.