Clinical Characteristics and Outcome Predictors in Drug-Resistant Tuberculosis: A Comprehensive Analysis

Abstract

Background: Drug-resistant tuberculosis (DR-TB) poses significant challenges to public health, with poor outcomes frequently observed in affected patients. This study aims to evaluate the characteristics and factors associated with poor outcomes in patients with drug-resistant pulmonary tuberculosis at Liwa Hospital from January 2018 to May 2023. Methods: A retrospective, cross-sectional single-center analysis was conducted on 408 patients admitted to Liwa Hospital. Among these, 28 patients diagnosed with drug-resistant tuberculosis (DR-TB) were selected for detailed analysis based on their treatment outcomes and clinical data. Inclusion criteria encompassed patients aged 18 years or older with confirmed drug-resistant TB, while patients younger than 18, those with latent tuberculosis, and those with extra-pulmonary tuberculosis were excluded. Results: The majority of patients were between 18-40 years old (60.7%), predominantly male (85.7%), and Asian (96.4%). Comorbidities included diabetes (46.4%) and hypertension (21.4%). Clinical characteristics revealed cough (28.6%) and fever with cough (7.1%) as common symptoms. Primary resistance was observed in 92.9% of cases, with 96.4% being newly diagnosed TB cases. Adverse drug events were minimal, with 7.1% experiencing nausea and vomiting. Radiological findings showed unilateral TB in 53.6% and cavitary TB in 57.1% of cases. Laboratory analysis indicated elevated HbA1c (9.83 ± 3.25), CRP (25.94 ± 5.16 mg/L), and white blood cell count (9.94 ± 4.59 x 10^9 cells/L). Rifampicin resistance was the most prevalent (42.9%), followed by isoniazid resistance (25.0%). Regarding treatment outcomes, age, hypertension, and diabetes mellitus were found to be significantly associated with poor outcomes in patients (p=0.05). Conclusion: The study identified significant associations between treatment outcomes and age, hypertension, and diabetes status, with higher proportions of poor outcomes observed in patients. Comprehensive management strategies targeting these factors are essential to improve outcomes in patients with drug-resistant TB. Further research is warranted to develop tailored interventions for this population.