Predictors for Mortality in Multidrug Resistant Pulmonary Tuberculosis Patients in a South Indian Region

Abstract

Background: Although various factors depicting the mortality in multi drug resistant tuberculosis available there exist no concise data on the factors contributing to mortality globally. The predictors for mortality in multi drug resistant tuberculosis patients vary from localities. Objectives: The study aimed to find the factors contributing to mortality in multi drug resistant tuberculosis in Warangal district of Telangana. Materials and Methods: The prospective study determining the predictors of mortality in multidrug resistant pulmonary tuberculosis patients had a sample size of 296. The follow-up of the patients was conducted for twenty four months to determine the treatment outcome. Patients’ mortality was noted from the hospital case sheets, relatives and healthcare facilitators’ viz., National tuberculosis elimination program supervisors, Auxiliary Nursing Midwifery in case of death at home. Patients’ demography was denoted in number and percentage. Predictors for mortality determined using binary logistic regression analysis. The predictor variables significant with p<0.2 in univariate analysis were considered for binary logistic regression analysis. The dependent variable was the occurrence of event - mortality and the independent variables chosen from the available literature. Results: The predictors for mortality identified as low body weight of 16-30kg (p=0.002; aOR=10.43); comorbids (p=0.002; aOR=3.21); severe radiological manifestations at admission to hospital (p=0.001; aOR=6.98) and incompliance to treatment (p=0.0001; aOR=5.06) in the present study. Conclusion: The factors identified for mortality in multidrug resistant tuberculosis patients are malleable and modifiable with timely follow-up of the patients. The results imply strengthening the anti-TB program with a multidisciplinary approach for a systematic follow-up of the patients and favorable treatment responses.