title: Characteristics and treatment outcomes of patients with multi-drug resistant tuberculosis at a tertiary care hospital in Peshawar, Pakistan.
abstract: OBJECTIVE
  To determine characteristics and treatment outcomes of multidrugs resistant tuberculosis (MDR-TB) patients and risk factors for poor outcomes in MDR-TB patients in a tertiary care hospital in Peshawar, Pakistan.
  
  
  METHODS
  This retrospective study was conducted at the Programmatic Management of Drug Resistant TB Unit, Lady Reading Hospital Peshawar, Pakistan and included all MDR-TB patients registered between January 2012 and December 2012. A special proforma was used for data collection. Analysis was performed using SPSS version 16, after exporting data from the proforma. Differences in proportions were assessed using Pearson's Chi square test whereas for predictors of poor outcomes, multivariate logistic regression analysis with Wald Statistical criteria using backward elimination method was performed.
  
  
  RESULTS
  The treatment success rate was 74.3%. In univariate analysis, poor outcomes were associated in patients with age ≥44 years (odds ratio [OR]=0.250; 95% confidence interval [CI]: 0.114-0.519, p=0.001), rural residence (OR=0.417; 95% CI: 0.18-0.937, p=0.03), lung cavitation (OR=0.22; 95% CI, 0.007-0.067, p=0.001), resistance to second line drugs (SLD) (OR=3.441; 95% CI: 1.579-7.497, p=0.001), and resistance to ofloxacin (OR=2.944; 95% CI: 1.361-6.365, p=0.005); whereas multivariate logistic regression analysis, poor outcomes were associated in patients with age ≥44 years (OR=0.249, 95% CI: 0.075-0.828, p=0.023), rural residence (OR=0.143, 95% CI: 0.052-0.774, p=0.032), and cavitatory lungs (OR=0.022, 95% CI: 0.007-0.072, p=0.000).
  
  
  CONCLUSIONS
  The MDR-TB patient needs special attention for better treatment outcomes. The presence of older age, rural area residence, resistance to ofloxacin, SLD resistance, and cavitary disease are independent prognostic factors for poor outcome in patients with MDR-TB.
authors.affiliation: Programmatic Management of Drug Resistant TB Unit, Lady Reading Hospital, Peshawar, Pakistan. E-mail. mali_smile2005@yahoo.com.
authors.forename: Mazhar A
authors.initials: MA
authors.lastname: Khan
authors.forename: Sumaira
authors.initials: S
authors.lastname: Mehreen
authors.forename: Anila
authors.initials: A
authors.lastname: Basit
authors.forename: Raza A
authors.initials: RA
authors.lastname: Khan
authors.forename: Faheem
authors.initials: F
authors.lastname: Jan
authors.forename: Irfan
authors.initials: I
authors.lastname: Ullah
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ihtesham
authors.forename: Afsar
authors.initials: A
authors.lastname: Khan
authors.forename: Ubaid
authors.initials: U
authors.lastname: Ullah
authors.forename: Arshad
authors.initials: A
authors.lastname: Javaid
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D010154:Pakistan; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents