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Weight variation increases the risk of death during the intensive phase of treatment among MDR-TB patients: A retrospective study
Author(s):
1. Abdul Majeed Akhtar: University Institute of Public Health, The University of Lahore,Lahore,Pakistan
2. Shamsa Kanwal: University Institute of Public Health, The University of Lahore,Lahore,Pakistan
3. Sufia Majeed: Department of Medicine, Mayo Hospital, Lahore, Pakistan.
4. Wasif Majeed: Institute of Applied Psychology, The University of Punjab, Lahore, Pakistan.
Abstract:
Objective: To estimate the predictors of death during intensive phase of Multidrug resistant tuberculosis treatment according to the weight of patients at the time of diagnosed. Methods: A retrospective study was conducted at three public hospitals in the Lahore, Punjab region, namely Jinnah Hospital, Mayo Hospital and Gulab Devi Hospital on 1,496 patients receiving treatment for MDR-TB from January 2018 to December 2020. Data were collected from electronically nominating and recording system of the hospitals. Data were fitted to Cox proportional hazards regression model with 95% confidence interval (CI) to evaluate the associations between predictors of death and weight of MDR-TB patients during the intensive phase of treatment. Results: This analysis revealed a MDR-TB mortality rate of 30% and the mortality rate due to MDR-TB during the intensive phase of treatment was 23%. The variables related to increased mortality among underweight patients were age more than 60 years (HR: 0.398, 95% CI: 0.314-0.504) , diabetes (HR: 1.496, 95% CI: 1.165-1.921), current smoking (HR: 0.465, 95% CI: 0.222-0.973), history of MDR-TB (HR: 0.701, 95% CI: 0.512-0.959) and culture positive at the time of diagnosed (HR: 0.499, 95% CI: 0.379-0.659) during the intensive phase of treatment. Conclusion: The high mortality rate among the underweight MDR-TB patients during the intensive phase of the treatment requires the nutritional support for malnourishment and ensured a close follow-up of the elderly patients with co-morbidities as well as family history of Tuberculosis.
Page(s): 1080-1085
Published: Journal: Pakistan Journal of Medical Sciences, Volume: 39, Issue: 4, Year: 2023
Keywords:
Mortality , Weight , Intensive phase , Multidrug Resistance Tuberculosis
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