Time-to-sputum culture conversion, treatment outcomes, and associated factors among multidrug-resistant tuberculosis patients in the Sidama region, Ethiopia: A retrospective follow-up study

Abstract Background Sputum-culture conversion is critical to follow-up treatment effectiveness in multidrug-resistant tuberculosis patients. However, the evidence regarding time-to-culture conversion, treatment outcomes, and the associated factors was sparse and inconsistent. Objective This study aimed to determine the time-to-culture conversion, treatment outcomes, and associated factors among multidrug-resistant tuberculosis in the Sidama Region from April 1 to December 31, 2024. Methods We conducted a retrospective follow-up study on 346 patients who enrolled from January 2013 to June 2024. The researchers collected data from the patient’s medical records using the standardized forms, entered the data, and analyzed it using SPSS 26 software. The researchers performed the analysis using the Kaplan-Meier model time-to-culture conversion, Cox proportional hazard ratio, and logistic regression models to assess factors associated with time-to-culture conversion and treatment outcomes, respectively. We considered an adjusted hazard ratio with a 95% CI and a P-value < 0.05 to decide the significance. Results Among the participants, 302 (87.3%) achieved culture conversion in a median time of 76 days (95% CI: 71-79, p < 0.05); 36 patients (10.4%) displayed a delayed conversion, with a median conversion time of 141 days while, 8 (2.3%) patients did not show culture conversion. Among the participants, 32 patients (9.2%) were not evaluated for their treatment outcomes. The treatment success rate was 234 (67.6%). The rates of cure, treatment completion, death, treatment failure, and loss to follow-up were 177 (51.2%), 57 (16.5%), 23 (6.6%), 5 (1.4%), and 52 (15%), respectively. Patients with a history of previous treatment failure had worse treatment outcome with an aHR of 6 (1-27), 95% CI, P = 0.002. Conclusions Most of the patients (87.3%) achieved culture conversion within three months. However, patients with a history of retreatment faced worse outcome, pointing to serious treatment follow-up to the patients.