Comorbidities and Treatment Outcomes in Patients Diagnosed with Drug-Resistant Tuberculosis in Rural Eastern Cape Province, South Africa
Background/Objectives: Tuberculosis (TB) remains a significant global health challenge, with drug-resistant tuberculosis (DR-TB) posing a greater threat due to difficulty in treatment. This study aimed to investigate the relationship between comorbidities and treatment outcomes in patients diagnosed...
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MDPI AG
2024-11-01
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| author | Mojisola Clara Hosu Lindiwe Modest Faye Teke Apalata |
| author_facet | Mojisola Clara Hosu Lindiwe Modest Faye Teke Apalata |
| author_sort | Mojisola Clara Hosu |
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| description | Background/Objectives: Tuberculosis (TB) remains a significant global health challenge, with drug-resistant tuberculosis (DR-TB) posing a greater threat due to difficulty in treatment. This study aimed to investigate the relationship between comorbidities and treatment outcomes in patients diagnosed with DR-TB in rural Eastern Cape using logistic regression. Methods: Data on patient characteristics, comorbidities, and treatment outcomes were extracted from the medical records and analyzed using Python version 3.8. and R version 4.1.1 software. A logistic regression model was used to determine the effects of selected variables on treatment outcomes of DR-TB cases. Results: Hearing loss and hypertension (HTN) were the most frequently observed comorbidities across various DR-TB cases, particularly rifampicin-resistant (RR), multidrug-resistant (MDR), and pre-extensively drug-resistant (pre-XDR-TB) cases. A hearing loss prevalence of 5.8% (26/445) was found among patients receiving treatment for TB, with the intensity of impairment ranging from mild to severe. Gender is significantly associated with the occurrence of HTN among these patients (<i>p</i>-value: 0.022). Comorbidities such as epilepsy, hearing loss, and HTN significantly impact treatment success, with higher risks of mortality and incomplete cure. Using logistic regression, obesity (OR = 3.0884; e = 1.1277; <i>p</i> = 0.0408) and HIV-positive status (OR = 0.4458; e = 0.8078; <i>p</i> = 0.0001) were highly likely and less likely associated with better treatment outcomes, respectively. The logistic regression model achieved an accuracy of 64.0%, a precision of 63.0%, and a recall of 95.0%, with an F-1 score of 76.0%. Conclusions: The findings underscore the importance of implementing integrated management strategies that address both DR-TB and its comorbidities, particularly in resource-limited settings where such patients are prevalent. Public health policies should incorporate strategies to provide nutritional assessments and interventions, particularly for individuals with low BMI. This could include food supplementation programs or partnerships with local food kitchens to ensure that patients have access to adequate nutrition during DR-TB treatment. |
| format | Article |
| id | doaj-art-c3eebeaf4c1f40afb7b2b761d6ee0b76 |
| institution | Kabale University |
| issn | 2079-9721 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diseases |
| spelling | doaj-art-c3eebeaf4c1f40afb7b2b761d6ee0b762024-11-26T18:00:16ZengMDPI AGDiseases2079-97212024-11-01121129610.3390/diseases12110296Comorbidities and Treatment Outcomes in Patients Diagnosed with Drug-Resistant Tuberculosis in Rural Eastern Cape Province, South AfricaMojisola Clara Hosu0Lindiwe Modest Faye1Teke Apalata2Department of Laboratory Medicine and Pathology, Faculty of Medicine and Health Sciences, Walter Sisulu University, Private Bag, Mthatha 5117, South AfricaDepartment of Laboratory Medicine and Pathology, Faculty of Medicine and Health Sciences, Walter Sisulu University, Private Bag, Mthatha 5117, South AfricaDepartment of Laboratory Medicine and Pathology, Faculty of Medicine and Health Sciences, Walter Sisulu University, Private Bag, Mthatha 5117, South AfricaBackground/Objectives: Tuberculosis (TB) remains a significant global health challenge, with drug-resistant tuberculosis (DR-TB) posing a greater threat due to difficulty in treatment. This study aimed to investigate the relationship between comorbidities and treatment outcomes in patients diagnosed with DR-TB in rural Eastern Cape using logistic regression. Methods: Data on patient characteristics, comorbidities, and treatment outcomes were extracted from the medical records and analyzed using Python version 3.8. and R version 4.1.1 software. A logistic regression model was used to determine the effects of selected variables on treatment outcomes of DR-TB cases. Results: Hearing loss and hypertension (HTN) were the most frequently observed comorbidities across various DR-TB cases, particularly rifampicin-resistant (RR), multidrug-resistant (MDR), and pre-extensively drug-resistant (pre-XDR-TB) cases. A hearing loss prevalence of 5.8% (26/445) was found among patients receiving treatment for TB, with the intensity of impairment ranging from mild to severe. Gender is significantly associated with the occurrence of HTN among these patients (<i>p</i>-value: 0.022). Comorbidities such as epilepsy, hearing loss, and HTN significantly impact treatment success, with higher risks of mortality and incomplete cure. Using logistic regression, obesity (OR = 3.0884; e = 1.1277; <i>p</i> = 0.0408) and HIV-positive status (OR = 0.4458; e = 0.8078; <i>p</i> = 0.0001) were highly likely and less likely associated with better treatment outcomes, respectively. The logistic regression model achieved an accuracy of 64.0%, a precision of 63.0%, and a recall of 95.0%, with an F-1 score of 76.0%. Conclusions: The findings underscore the importance of implementing integrated management strategies that address both DR-TB and its comorbidities, particularly in resource-limited settings where such patients are prevalent. Public health policies should incorporate strategies to provide nutritional assessments and interventions, particularly for individuals with low BMI. This could include food supplementation programs or partnerships with local food kitchens to ensure that patients have access to adequate nutrition during DR-TB treatment.https://www.mdpi.com/2079-9721/12/11/296drug-resistant tuberculosistreatment outcomescomorbidityhearing losshypertensionnon-communicable diseases |
| spellingShingle | Mojisola Clara Hosu Lindiwe Modest Faye Teke Apalata Comorbidities and Treatment Outcomes in Patients Diagnosed with Drug-Resistant Tuberculosis in Rural Eastern Cape Province, South Africa Diseases drug-resistant tuberculosis treatment outcomes comorbidity hearing loss hypertension non-communicable diseases |
| title | Comorbidities and Treatment Outcomes in Patients Diagnosed with Drug-Resistant Tuberculosis in Rural Eastern Cape Province, South Africa |
| title_full | Comorbidities and Treatment Outcomes in Patients Diagnosed with Drug-Resistant Tuberculosis in Rural Eastern Cape Province, South Africa |
| title_fullStr | Comorbidities and Treatment Outcomes in Patients Diagnosed with Drug-Resistant Tuberculosis in Rural Eastern Cape Province, South Africa |
| title_full_unstemmed | Comorbidities and Treatment Outcomes in Patients Diagnosed with Drug-Resistant Tuberculosis in Rural Eastern Cape Province, South Africa |
| title_short | Comorbidities and Treatment Outcomes in Patients Diagnosed with Drug-Resistant Tuberculosis in Rural Eastern Cape Province, South Africa |
| title_sort | comorbidities and treatment outcomes in patients diagnosed with drug resistant tuberculosis in rural eastern cape province south africa |
| topic | drug-resistant tuberculosis treatment outcomes comorbidity hearing loss hypertension non-communicable diseases |
| url | https://www.mdpi.com/2079-9721/12/11/296 |
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