Abstract:

Objective: To analyze the status of adverse treatment outcomes and influencing factors of drug-resistant tuberculosis patients in Guangzhou. Methods: A retrospective cohort study was conducted in 677 drug-resistant tuberculosis patients registered and treated in Guangzhou Chest Hospital from January 1, 2016 to December 31, 2020. The medical record of them were from the China Tuberculosis Management Information System. And the occurrence and influencing factors of adverse treatment outcomes were analyzed. Results: Of the 677 patients, 193 (28.5%) were successfully treated, 280 (41.4%) were under treatment, 204 (30.1%) had adverse treatment outcomes (13 stopped treatment adverse reactions, 9 failed, 32 died, and 150 failed to be followed up), and the median survival time for patients with adverse treatment outcomes was 729 days. Multivariate Cox model analysis showed that non-Guangzhou registration, complicated with diabetes, interprovincial mobility and older age were risk factors of adverse treatment outcomes in drug-resistant TB patients (HR (95%CI)=1.74 (1.21-2.49), P=0.002; HR (95%CI)=1.59 (1.10-2.32), P=0.015; HR (95%CI)=2.29 (1.26-4.18), P=0.007; HR (95%CI)=1.01 (1.00-1.03), P=0.011, respectively), and multidrug resistance was a protective factor (HR (95%CI)=0.53 (0.36-0.79), P=0.002). Conclusion: The incidence of adverse treatment outcomes in drug-resistant tuberculosis patients was high, and the treatment and long-term management of drug-resistant tuberculosis patients should be strengthened, especially those who complicated with diabetes, moved from other provinces, had an older age and could not enjoy preferential medical treatment in the city due to registered residence registrations.

Key words: Tuberculosis,multidrug-resistant, Treatment outcome, Analysis of factors, statistical