TREATMENT OUTCOMES AND ASSOCIATED FACTORS OF MULTIDRUG- RESISTANT TUBERCULOSIS PATIENTS TREATED WITH BEDAQUILINE AND/OR DELAMANID IN NORTHWEST AMHARA, ETHIOPIA

Abstract

introduction: Multidrug resistant tuberculosis (MDRTB) treatment outcome is the most important direct measurement of the effectiveness of the MDRTB control program. MDR-TB is an emerging public health problem and treatment often involves drugs that can have significant side effects. However, little is known about treatment outcome of MDR-TB among the patients treated with Bedaquiline and/or Delamanid. Objective: To assess treatment outcomes of MDR-TB treated with Bedaquiline and/or Delamanid and their predictors in north-west Amhara, Ethiopia. Methods: A retrospective cohort study was conducted among MDR-TB patients treated with Bedaquiline and/or Delamanid from April 2018–march 2024 GC at North-western Amhara Hospitals. Bivariable and multivariable logistic regression were carried out to identify factors associated with poor treatment outcome. Adjusted odds ratio (AOR) with 95% confidence interval and variables with a p-value< 0.05 were considered significantly associated with poor treatment outcome. Results: A total of 324 study participants were enrolled in the study. The unsuccessful treatment outcome was 18.83% with (95% CI: 14.92-23.48). Almost two third 65.43% experienced at least 1 kind of ADE; the 3 most common adverse effects were Nausea and vomiting 53.70%, Anemia 38.89% and peripheral neuropathy 31.79%. Median time of sputum culture conversion was 2 months with an Inter-Quartile Range (IQR) of 2-3 months: 61.77% of the study respondent had sputum culture conversion within two months. Being underweight (AOR= 2.87, 95%, CI: 1.13-7.33), HIV positive patients (AOR= 3.21, 95%, CI: 1.51-6.83), previously treated TB patients (AOR=3.71, 95%, CI: 1.46-9.39) and TB patients with adverse drug event (AOR= 3.11, 95%, CI: 1.13-8.56) were significantly associated with unsuccessful treatment outcome. Conclusions: The unsuccessful treatment outcome among patients with MDR-TB treated with Bedaquiline and/or Delamanid were significant. Almost two third of participants experienced adverse drug event, Patients with MDR-TB should have rigorous side effect management during treatment. It is better to pay great attention to underweight patient, HIV positive patient, previously treated TB patient and TB patients with adverse drug event to reduce the risk of developing an unsuccessful treatment outcome.