Survival and predictors of mortality among patients under multi-drug resistant tuberculosis treatment in Ethiopia: St. Peter’s Specialized Tuberculosis Hospital, Ethiopia

Joint Event on 6^th International Conference and Exhibition on GMP, GCP & Quality Control & 7^th International Conference and Exhibition on Pharmaceutical Regulatory Affairs and IPR

September 25-26, 2017 Chicago, USA

Theodros Getachew Zemedu, Alemayehu Bayray and Berhe Weldearegay

Ethiopian Public Health Institute, Ethiopia
Mekelle University, Ethiopia

Posters & Accepted Abstracts: Pharm Regul Aff

Abstract :

Statement of the Problem: Multi-drug resistance tuberculosis (MDR-TB) is an increasing global problem. The extent and burden of MDR-TB varies significantly from country to country. Survival of MDR-TB treatment is not described in Ethiopia. Therefore, examining a cohort who received second-line therapy for MDR-TB to determine overall survival has a great importance. The main purpose of this study was to assess survival and predictors of mortality among patients under MDR-TB treatment in Ethiopia: St. Peter�s Specialized TB Hospital, Addis Ababa, Ethiopia. Methodology & Theoretical Orientation: A retrospective analysis of records was conducted from Oct, 2011 to May, 2012 among cohorts of MDR-TB patients in St. Peter�s Specialized TB Hospital that starts treatment from February 2009. Data were collected using checklist from 188 patients� record that is determined and analyzed using the STATA Statistical package, Version 11.0. Risk was estimated for the entire follow-up time corresponding to each event occurrence using Kaplan-Meier method and the covariates are fitted to Cox proportional hazard regression model. Findings: The 188 patients were followed for a total of 79,600 person-days. Median follow up time was 466.5 days or 1.28 years. Among the total subjects, 87 (46.28%) are male and the rest 101 (53.72%) are female with a median age of 27 years. There were 29 (15.43%) known deaths (incidence rate: 3.6 per 10,000 person-days). Survival rate at 6, 12, 18 and 24 months of treatment were 88.53%, 85.83%, 82.71% and 78.95% respectively. The mean survival time for patients under MDR-TB was 9.7 years. Comparison of the groups showed that there is a significant difference in the probability of surviving between HIV status, smoking status, therapeutic delay, number of first line resistant drugs at initiation, co-morbidities, region and clinical complication. In multivariate Cox proportional hazard regression, factors independently associated with mortality of patients were smoking (HR: 4.01, 95% CI 1.42-11.37, P=0.009), therapeutic delay >1 month (HR: 3.61, 95% CI 1.41-9.20, P=0.007), HIV seropositive (HR: 5.94, 95% CI 2.40-14.72, P<0.0001) and clinical complication (HR: 1.90, 95% CI 1.52-2.39, P<0.001). Conclusion & Significance: Survival of patients was higher and higher hazard of death was noted in patients who started treatment after a month, in smoker, HIV positive and patients who develop a clinical complication. Although survival is good, reinforcing the existing treatment program will further improve patients� survival in Ethiopia.