Survival and predictors of mortality from multidrug resistant tuberculosis (MDR-TB) among patients treated at MDR-TB Referal Hospitals in Ethiopia: A retrospective cohort study

The extent and burden of MDR-TB varies significantly from country to country. In Africa, fewer than half of patients receiving therapy for multidrug-resistant TB (MDR TB) are successfully treated. Even though MDR-TB treatment was started in 2009 survival of MDR-TB treatment particularly of adverse treatment outcome is not studied in national level.  Institution based retrospective cohort study was conducted at randomly selected four treatment Initiative Centers (TIC) & referral hospitals in Ethiopia. Data was collected using standardized checklist by trained professionals through reviewing records of all patients ever enrolled. Cox- proportional hazard regression model was built of the 494 records reviewed, 462 met the inclusion criteria. These patients were followed for 202250 person-day of observation; during the follow up period 38 (8.2%) patients were died making overall incidence density rate of 6.79 (95% CI=5.42-8.78) per 100 Person year. Survival at the end of 1st and 4th month was 98.2% and 92.3% respectively, while the overall mean survival time was 24.82(95%CI=22.8-25.72) months. Drugs side effect 3 (95 % CI [2.5-4.3, medical diagnosis other than TB 3.3 (95 % CI [1.7-5.6], HIV sero-status 2.7 (95 % CI [3.4-9.11] and bigger base line body were independently and significantly predicted mortality of MDR-TB patients. The incidence of death and treatment outcomes was in acceptable ranges, yet it needs due attention. Intervention to further reduce deaths has to focus on patients with co-morbidities, HIV, adverse effect and smaller base line body weight. Key words:  'MDR-TB, Survivable, Mortality, Ethiopia.