Evaluating Treatment Outcomes in Special Populations with Multidrug- and Extensively Drug-Resistant Tuberculosis: A Comparative Cohort Study

Background: Drug-resistant tuberculosis (DR-TB) remains a major global health challenge. Treatment for multidrug-resistant and rifampicin-resistant TB (MDR/RR-TB) is often prolonged, toxic, and burdensome, contributing to poor outcomes. Despite improvements, MDR/RR-TB still has a global mortality rate of ~15%. Methods: A prospective cohort study was conducted at Alimov National Tuberculosis Hospital from June 2023 to December 2024. It included all inpatients with MDR or extensively drug-resistant TB (XDR-TB) treated under the National TB Control Program. Results: Among 163 patients, short-term regimens were used in 30 patients (18.2%), including m-STTR (8.5%), m-STTR with delamanide (1.2%), and 6-month BPaLM (8.5%). Long-term standard regimens were used in 53 patients (32.5%). For XDR-TB, BPaL and BPaLC were used in 9 patients (5.5%), long-term regimens with delamanide in 59 patients (35.2%), and individualized regimens in 14 patients (8.6%). Conclusion: Among 155 discharged patients, radiological improvement occurred in 105 (67.7%) and sputum culture conversion in 127 (81.9%). In the total cohort (n=163), these rates were 64.4% and 77.9%, respectively. MDR-TB patients (n=81) had 80.5% conversion and 65.4% cavity closure; XDR-TB patients (n=82) had 76.8% and 63.4%, respectively.