Evaluation of risk factors associated with drug-resistant tuberculosis in Yemen: data from centres with high drug resistance
Abstract Background The World Health Organization (WHO) has reported that Yemen has a high burden of drug resistance and a worrying shortage of implemented diagnostic methods and drug treatment regimens. Therefore, in this study, we evaluated the risk factors associated with multidrug-resistant tube...
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-019-4069-1 |
| _version_ | 1818038170127695872 |
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| author | Ammar Ali Saleh Jaber Baharudin Ibrahim |
| author_facet | Ammar Ali Saleh Jaber Baharudin Ibrahim |
| author_sort | Ammar Ali Saleh Jaber |
| collection | DOAJ |
| description | Abstract Background The World Health Organization (WHO) has reported that Yemen has a high burden of drug resistance and a worrying shortage of implemented diagnostic methods and drug treatment regimens. Therefore, in this study, we evaluated the risk factors associated with multidrug-resistant tuberculosis (MDR-TB) and explored the poor TB management in Yemen. Methods Between January 2014 and December 2016, we enrolled 135 patients with MDR-TB from drug resistance programmes at four major TB centres in Yemen for this prospective study. After exclusion of 20 patients, treatment outcomes were reported for 115 patients who attended a series of follow-ups. Results A total of 115 patients with MDR-TB were analysed from the four main TB centres in Yemen. Most patients (35.2%) were from the Aden TB centre. A success rate of 77.4% was reported for TB treatment. Of the 115 patients, 69.6% were resistant to two drugs, 18.3% were resistant to three drugs, and 12.2% were resistant to four drugs. During the intensive phase of treatment, 19 patients (16.5%) reported one or more adverse events. A multivariate logistic regression analysis revealed that a baseline body weight of ≤40 kg [p = 0.016; adjusted odds ratio (AOR) = 25.09], comorbidity (p = 0.049; AOR = 4.73), baseline lung cavities (p = 0.004; AOR = 15.32), and positive culture at the end of the intensive phase (p = 0.009; AOR = 8.83) were associated with the unsuccessful treatment outcomes in drug-resistant TB patients. Conclusions The success rate achieved after treatment was below the levels established by the WHO End TB Strategy (90%) and the United Nations Sustainable Development Goals (80%). Identification of risk factors associated with MDR-TB in Yemen is essential because it allows health workers to identify high-risk patients, especially in the absence of a second-line treatment or a laboratory diagnostic method. The Yemen National Tuberculosis Control Program should formulate new strategies for early detection of MDR-TB and invest in new programmes for MDR-TB management. |
| first_indexed | 2024-12-10T07:38:29Z |
| format | Article |
| id | doaj.art-261718190d964008bd38a54577940ec2 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-10T07:38:29Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-261718190d964008bd38a54577940ec22022-12-22T01:57:21ZengBMCBMC Infectious Diseases1471-23342019-05-011911910.1186/s12879-019-4069-1Evaluation of risk factors associated with drug-resistant tuberculosis in Yemen: data from centres with high drug resistanceAmmar Ali Saleh Jaber0Baharudin Ibrahim1Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains MalaysiaDepartment of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains MalaysiaAbstract Background The World Health Organization (WHO) has reported that Yemen has a high burden of drug resistance and a worrying shortage of implemented diagnostic methods and drug treatment regimens. Therefore, in this study, we evaluated the risk factors associated with multidrug-resistant tuberculosis (MDR-TB) and explored the poor TB management in Yemen. Methods Between January 2014 and December 2016, we enrolled 135 patients with MDR-TB from drug resistance programmes at four major TB centres in Yemen for this prospective study. After exclusion of 20 patients, treatment outcomes were reported for 115 patients who attended a series of follow-ups. Results A total of 115 patients with MDR-TB were analysed from the four main TB centres in Yemen. Most patients (35.2%) were from the Aden TB centre. A success rate of 77.4% was reported for TB treatment. Of the 115 patients, 69.6% were resistant to two drugs, 18.3% were resistant to three drugs, and 12.2% were resistant to four drugs. During the intensive phase of treatment, 19 patients (16.5%) reported one or more adverse events. A multivariate logistic regression analysis revealed that a baseline body weight of ≤40 kg [p = 0.016; adjusted odds ratio (AOR) = 25.09], comorbidity (p = 0.049; AOR = 4.73), baseline lung cavities (p = 0.004; AOR = 15.32), and positive culture at the end of the intensive phase (p = 0.009; AOR = 8.83) were associated with the unsuccessful treatment outcomes in drug-resistant TB patients. Conclusions The success rate achieved after treatment was below the levels established by the WHO End TB Strategy (90%) and the United Nations Sustainable Development Goals (80%). Identification of risk factors associated with MDR-TB in Yemen is essential because it allows health workers to identify high-risk patients, especially in the absence of a second-line treatment or a laboratory diagnostic method. The Yemen National Tuberculosis Control Program should formulate new strategies for early detection of MDR-TB and invest in new programmes for MDR-TB management.http://link.springer.com/article/10.1186/s12879-019-4069-1Drug resistanceKhatTuberculosisYemen |
| spellingShingle | Ammar Ali Saleh Jaber Baharudin Ibrahim Evaluation of risk factors associated with drug-resistant tuberculosis in Yemen: data from centres with high drug resistance BMC Infectious Diseases Drug resistance Khat Tuberculosis Yemen |
| title | Evaluation of risk factors associated with drug-resistant tuberculosis in Yemen: data from centres with high drug resistance |
| title_full | Evaluation of risk factors associated with drug-resistant tuberculosis in Yemen: data from centres with high drug resistance |
| title_fullStr | Evaluation of risk factors associated with drug-resistant tuberculosis in Yemen: data from centres with high drug resistance |
| title_full_unstemmed | Evaluation of risk factors associated with drug-resistant tuberculosis in Yemen: data from centres with high drug resistance |
| title_short | Evaluation of risk factors associated with drug-resistant tuberculosis in Yemen: data from centres with high drug resistance |
| title_sort | evaluation of risk factors associated with drug resistant tuberculosis in yemen data from centres with high drug resistance |
| topic | Drug resistance Khat Tuberculosis Yemen |
| url | http://link.springer.com/article/10.1186/s12879-019-4069-1 |
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