Weight variation increases the risk of death during the intensive phase of treatment among MDR-TB patients: A retrospective study

Abdul Majeed Akhtar; Shamsa Kanwal; Sufia Majeed; Wasif Majeed

doi:10.12669/pjms.39.4.7025

Weight variation increases the risk of death during the intensive phase of treatment among MDR-TB patients: A retrospective study

Pak J Med Sci. 2023 Jul-Aug;39(4):1080-1085. doi: 10.12669/pjms.39.4.7025.

Authors

Abdul Majeed Akhtar¹, Shamsa Kanwal², Sufia Majeed³, Wasif Majeed⁴

Affiliations

¹ Dr. Abdul Majeed Akhtar, Ph.D. University Institute of Public Health, The University of Lahore, Lahore, Pakistan.
² Dr. Shamsa Kanwal, Ph.D University Institute of Public Health, The University of Lahore, Lahore, Pakistan.
³ Dr. Sufia Majeed, MBBS. Department of Medicine, Mayo Hospital, Lahore, Pakistan.
⁴ Wasif Majeed, M.Phil. 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.

Keywords: Intensive phase; Mortality; Multidrug Resistance Tuberculosis; Weight.