Poor treatment outcome and its predictors among drug-resistant tuberculosis patients in Ethiopia: A systematic review and meta-analysis

Int J Infect Dis. 2020 Sep;98:420-439. doi: 10.1016/j.ijid.2020.05.087. Epub 2020 Jul 6.

Abstract

Objective: To assess poor treatment outcomes and their predictors among drug-resistant tuberculosis patients treated in Ethiopia.

Methods: Data were searched from both electronic databases and other sources. From the whole search, 404 articles were reviewed and 17 articles that fulfilled the inclusion criteria were included in the analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed and Joanna Briggs Institute Critical Appraisal checklist was used for assessing the quality. Risk of bias was assessed using forest plot and Egger's regression test. Data were analyzed using STATA version 15 and Review Manager Software version 5.3.

Results: The overall pooled proportion of poor treatment outcome and mortality was 17.86% and 15.13% respectively. The incidence density rate of poor treatment outcome and mortality was 10.41/1000 person-months and 9.28/1000 person-months respectively. Survival status and successful treatment outcomes were 76.97% and 63.82% respectively. HIV positivity, non-HIV comorbidities, clinical complications, extrapulmonary involvement, undernutrition, anemia, treatment delay, lower body weight, and older age were the predictors of poor treatment outcome.

Conclusion: Better survival and treatment success rates were noted in Ethiopia as compared to the global average. The majority of the poor treatment outcomes occurred within the intensive phase. Early initiation of anti-tuberculosis treatment would be important for successful treatment outcomes.

Keywords: Drug-resistant; Ethiopia; Multi-drug resistant tuberculosis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / therapeutic use*
  • Ethiopia / epidemiology
  • Female
  • Humans
  • Male
  • Time-to-Treatment
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / epidemiology
  • Tuberculosis, Multidrug-Resistant / microbiology
  • Tuberculosis, Multidrug-Resistant / mortality
  • Young Adult

Substances

  • Antitubercular Agents