Clinical Characteristics and Treatment Outcome of Multidrug-Resistant Tuberculosis (MDR-TB) in a Tertiary Centre in Malaysia: A Two-year Experience

Authors:
Publisher website
Google Scholar
Abstract
Introduction: The burden of MDR-TB leads to increment in healthcare cost and long treatment duration. Studying the disease characteristics and treatment outcome would assist the clinician in managing it. Objectives: To determine the MDR-TB treatment outcome in our centre and treatment side effects. We hypothesize that certain clinical characteristics are associated with poorer treatment outcome. Methods: A retrospective study was conducted to review the medical records of all MDR-TB patients registered in Institute of Respiratory Medicine, Kuala Lumpur from 2015-2016. Demographic data, disease characteristics, treatment outcome and adverse drug reactions were recorded and analyzed. Results: 63 patients were diagnosed to have MDR-TB, comprised of 42 males and 21 females, with mean age of 39.6±12.6 year. Primary and acquired MDR-TB were 33.3% and 66.7% respectively. Majority of the cases were pulmonary tuberculosis (88.9%) and 63.5% were smear positive. 71.4% were treated with conventional MDR-TB regimen; mean treatment duration are 13±8.1 months. MDR-TB treatment success rate in our centre was 49.2%(31/63). 41.3% of MDR-TB patients have poor outcome, including 20 treatment defaults, 2 relapse MDR-TB and 4 mortalities. 6 patients were transferred to other centres. Male gender(p=0.006) and smoker(p=0.018) were associated with poor treatment outcome. 66.7% patients developed adverse drug reactions such as vomiting (15.8%), hypothyroidism (15.8%), psychotic symptoms (14%) and ototoxicity (10.5%). Conclusions: About half of the MDR-TB cases in our centre achieved successful treatment outcome. Poor treatment outcome was seen in male and smoker.