Risk Factors of Mortality among Patients with Multi-Drug Resistant Tuberculosis in Addis Ababa and Gondar, Ethiopia
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Date
2015-06
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Addis Abeba university
Abstract
Multi-drug resistant TB (MDR-TB) occurs when the causative agent, Mycobacterium tuberculosis,
becomes resistant to isonazid and rifampin, the two most effective drugs commonly used to treat TB.
Despite high rates of MDR-TB in Ethiopia, little data exist on the prevalence of or risk factors for drugresistant
tuberculosis.
The objective of this study was to assess rates of and risk factors for MDR-TB in ALERT Hospital, Addis
Ababa and Gondar University Teaching and Referral Hospital, Gondar, Ethiopia.
The study included 342 MDR-TB patients (142 from ALERT hospital and 200 from UOGTRH) under
treatment from August, 2011 to August, 2014 for whom data for variables of interest were complete.
Descriptive statistics, univariate and multivariate analyses were used as analytic methods. The Kaplan-
Meier method was used to estimate the survival time and Cox’s regression model was employed to
identify the covariates that may have statistical significant effect on the survival of MDR-TB patients.
The descriptive analysis indicates that out of the total 342 individuals, 37(10.8%) died; 11 and 12 deaths
occurred in the first and the second three months of MDR-TB treatment follow up, respectively. The
median survival for MDR-TB patients was 16 months. Factors associated with increased risk of mortality
were: having clinical complication ( 4.7161; 95%; 2.1861 – 10.1740), resistance to INH, RIF
and at least one of other drugs (E, STM, KAN, AMK & CPM) 2.9771; 95%; 1.3586 −
6.5238), smoking ( 3.17; 95%; 1.32 − 7.64), weight ( 0.9093; 95%; 0.8760 − 0.9440)
and age ( 1.2199; 95%; 1.0681 − 1.3933).
The mortality rate of patients was high at the earlier times of treatment. Laboratory and clinical factors
were associated with increased risk of mortality. Thus, those patients with poor laboratory/clinical
characteristics should be identified and treated before they progress to advanced disease stages
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Mortality among Patients with Multi