Unfavourable outcomes among patients with MDR-TB on the standard 24-month regimen in Maharashtra, India
Objectives: To assess the treatment outcomes and the timing and risk factors for unfavourable treatment outcomes, with a focus on death and loss to follow-up (LTFU).
Method: This was a retrospective cohort study involving a review of PMDT records. Treatment outcomes were reported on 31 December 2014.
Results: Of 4024 patients, treatment success was recorded in 1168 (29%). Unfavourable outcomes occurred in 2242 (56%), of whom 857 (21%) died and 768 (19%) were lost to follow-up. Treatment outcomes were missing on record review for 375 (9%) patients, and 239 (6%) were still undergoing treatment. Half of LTFU occurred within 3 months, and more than four fifths of deaths occurred after 6 months of treatment. Human immunodeficiency virus infection, being underweight, age 15 years, male sex and pulmonary TB were the main risk factors for death, LTFU or other unfavourable treatment outcomes.
Conclusion: The study found poor treatment outcomes in patients with MDR-TB registered for treatment in Maharashtra, India. Interventions are required to address the high rates of LTFU and death.
Keywords: India; death; loss to follow-up; multidrug-resistant tuberculosis; operational research
Document Type: Research Article
Affiliations: 1: World Health Organization, Country Office for India, New Delhi, India 2: International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India 3: Department of Community Medicine, Employees' State Insurance Corporation Medical College and Post Graduate Institute of Medical Sciences and Research, Bangalore, India
Publication date: 21 June 2017
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