Impact of Co-morbidities on Treatment Outcome of Multidrug-Resistant Tuberculosis in Khyber Pakhtunkhwa

Abstract

Introduction In the ongoing battle against both drug-susceptible and drug-resistant tuberculosis (DR-TB), multi-morbidity is becoming more and more acknowledged as a severe public health hazard. Co-morbidities should be adequately handled while treating MDR tuberculosis by enlisting the help of specialists from other fields. Objective To analyze various co-morbidities and its effect on final outcome of multi-drug resistant tuberculosis patients. Materials and methods: Study design and settings: This prospective descriptive study was carried at department of pulmonology, Lady Reading Hospital, Peshawar, from 1st June 2021 till 30th May 2022. Sampling: A total of 157 participants with multi-drug resistant tuberculosis were registered which was confirmed based on PCR reporting resistance of the pathogen towards isoniazid and rifampicin. Co-morbidities were assessed in terms of diabetes mellitus, COPD, HIV and CKD. Analysis: Data analysis was performed using SPSS version 24. Results Male to female ratio was 1.7: 1. Age of the patients ranged from 20 to 60 years with mean age of 39. 37 ± 6.143 years. Mean BMI of the patients was 23.285 ± 2.5843 kg/m2. Diabetes mellitus was the most frequent comorbidity observed in 48 patients (30.6%), followed by COPD in 33 patients (21.0%). This study showed that successful outcome of the study cases was 112 (71.4%) and unsuccessful outcome was 45 (28.6). Crosstabulation between comorbidities and final outcome showed that positive significant association was found among comorbidities and unsuccessful outcome (P-value <0.005) Conclusion Comorbidity is common among multidrug-resistant tuberculosis individuals in our local population. The most common concurrent illnesses is diabetes mellitus. Authorities must explore the involvement of additional professions, particularly endocrinologists.