Drug-resistant tuberculosis in Malaysia: Prevalence, characteristics, and treatment outcomes

Drug-resistant tuberculosis (DR-TB) poses a serious global health threat, leading to high morbidity and mortality rates. Malaysia has witnessed an increase in DRTB cases, necessitating research into trends and characteristics. This study aims to determine the prevalence and describe the characteristics and treatment outcomes of DR-TB cases in Malaysia from 2016 to 2020.

A retrospective record review was carried out, utilising secondary data obtained from the TB registry of Selangor and Wilayah Persekutuan Kuala Lumpur. All registered DR-TB cases between 2016 and 2020 that met the study criteria were analysed descriptively using SPSS software version 27.

Of 443 cases of registered DR-TB over 5 years, 430 cases fulfilled the study criteria. The prevalence of DR-TB increased from 0.27 to 1.79 per 100,000 population between 2016 and 2020. The average age was 40.96 years, majority were males (70.7%), Malaysian (79.3%), with Malays comprising 50.2%. Most patients had up to secondary school education (51.9%), married (57.0%), employed (53.3%) and 34.9% were smokers. For clinical characteristics, 23.5% had diabetes, and 10.9% were HIVpositive. Retreatment cases accounted for half the total, and 83.9% had positive smear results. Minimal chest X-ray lesions were observed in 54.4% of cases. The majority (66.7%) received supervised treatment from healthcare providers after being diagnosed with DR-TB, and 37.4% had more than one anti-TB resistance. Favourable treatment outcomes were observed in 56.7% of cases, while 42.1% had unfavourable outcomes, mainly due to loss to follow-up (49.7%), death (42.6%) and treatment failure (7.7%).

The rising cases of DR-TB call for comprehensive public health interventions and stakeholder commitment to reduce its occurrence and transmission. These findings provide valuable guidance for policymakers in strengthening DR-TB control and prevention strategies.