Factors affecting outcome of longer regimen multidrug-resistant tuberculosis treatment in West Java Indonesia: A retrospective cohort study

PLoS One. 2021 Feb 8;16(2):e0246284. doi: 10.1371/journal.pone.0246284. eCollection 2021.

Abstract

Background: Multidrug-resistant tuberculosis had high treatment failure and mortality. Success rate of treatment currently 56% at global level, 48% in Indonesia and 36% in West Java province, the most populated province and surround Jakarta, the capitol of Indonesia.

Objective: This study aimed to evaluate factors affecting success of multidrug-resistant tuberculosis treatment in patients using longer treatment regimen in West Java Indonesia.

Methods: This was a retrospective cohort study of multidrug-resistant tuberculosis patients treated with longer regimen at Hasan Sadikin General Hospital from January 2015 to December 2017. Potential risk factors associated with the treatment outcome were analyzed using multiple logistic regression.

Results: A total of 492 patients were enrolled during the study period. Fifty percents multidrug-resistant tuberculosis patients had successful treatment outcome. Age ≤45 years, male, normal body mass index, no previous tuberculosis treatment, culture conversion ≤2 months, acid fast bacilli sputum smear ≤+1 were independent factors associated with increased treatment success. Sputum culture conversion ≤2 months was the major factor affecting successful outcome (RR 2.79; 95% CI: 1.61-4.84; p-value<0.001). Human Immunodeficiency Virus infection, chronic kidney disease, and cavitary lesion were independent risk factors for unfavourable outcome.

Conclusion: Age, gender, body mass index, tuberculosis treatment history, time of sputum conversion, acid fast bacilli sputum smear, HIV infection, chronic kidney disease, and cavitary lesion can be used as predictors for longer multidrug-resistant tuberculosis treatment regimen outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Antitubercular Agents / administration & dosage*
  • Antitubercular Agents / therapeutic use
  • Drug Administration Schedule
  • Female
  • Humans
  • Indonesia
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sex Factors
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Pulmonary / drug therapy*

Substances

  • Antitubercular Agents

Grants and funding

CP received funding from Lembaga Pengelola Dana Pendidikan Republic of Indonesia (LPDP RI) in the ammount of IDR 7.265.000 Funder Website: https://www.lpdp.kemenkeu.go.id. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.