Drug-resistant tuberculosis treatment success predictors in Namibia

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Drug-resistant tuberculosis (DR-TB) poses a significant global health challenge, hindering efforts to eradicate the disease by 2035.
• Understanding the factors influencing DR-TB treatment outcomes is crucial, particularly in high-burden regions like sub-Saharan Africa where such data is often lacking.

Purpose of the Study:

• To identify predictors and patterns of treatment success rates (TSRs) for DR-TB in Namibia.
• To provide evidence-based recommendations for national TB programs to improve DR-TB treatment outcomes.

Main Methods:

• A retrospective observational cohort study was conducted using a nationwide DR-TB database from 2014 to 2019.
• Multivariate logistic regression analysis was employed to determine independent predictors of successful treatment outcomes in DR-TB patients.

Main Results:

• The overall TSR for DR-TB in Namibia was 66.5%, with a marginal increase observed over the study period.
• Factors associated with lower treatment success included being female, younger age (under 15 years), Namibian nationality, and bilateral pulmonary disease.
• Conversely, baseline monoresistance was associated with a higher likelihood of treatment success.

Conclusions:

• Despite improvements, DR-TB TSRs in Namibia fall short of global targets and exhibit variability based on patient demographics and clinical presentation.
• Targeted interventions focusing on high-risk patient groups (e.g., females, young individuals, those with bilateral pulmonary TB) and community-based adherence strategies are recommended.
• Leveraging the expertise of clinical pharmacists should also be explored to enhance treatment outcomes.