Evaluation Of Management, Treatment Outcomes And Health Related Quality Of Life Of Multidrug Resistant Tuberculosis Patients In Peshawar, Pakistan
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Date
2016-12
Authors
Ahmad, Nafees
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Globally, Pakistan is a multidrug resistant tuberculosis (MDR-TB) high burden country. Although, programmatic management of drug resistant TB (PMDT) in the country is initiated in 2010, but little is known about the management and treatment outcomes of MDR-TB patients from Pakistan. For this purpose, a total of 298 MDR-TB patients treated at the PMDT unit of Lady Reading Hospital Peshawar were included in an observational cohort study. Patients were followed until a treatment outcome was recorded. The majority of patients (55.8%) were resistant to second line anti-TB drugs (SLD), mainly a fluoroquinolone (52.7%). Patients with previous TB treatment at private and public private mix sectors were significantly more likely to be ofloxacin resistant. More than half of them (53.6%) achieved sputum culture conversion within first two months of treatment. In multivariate binary logistic regression analysis, resistance to fluoroquinolone and cavitary lung disease emerged as risk factors for delayed culture conversion. Adverse events were experienced by 70.1% patients, but led to TB treatment regimen modification for only 18.9%. Patients with baseline body weight >40 kg were significantly more likely to develop adverse events. The majority of patients (75.1%) achieved successful treatment outcome. In multivariate binary logistic regression analysis, patient’s age >40 years, baseline body weight <40 kg, resistance to fluoroquinolone, cavitary lung disease and regimen modification due to adverse events emerged as risk factors for unsuccessful treatment outcomes. Moreover, despite potential detrimental effects of MDR-TB on patients Health Related Quality of Life (HRQoL), there is lack of information regarding the effects of MDR-TB treatment on patients’ HRQoL.
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Keywords
Health related quality of life of multidrug resistant , tuberculosis patients in Peshawar, Pakistan