Evaluation of Treatment Outcomes for Patients with Multidrug-Resistant Tuberculosis Registered in Thailand’s National Tuberculosis Information Program, Fiscal Year 2022 to 2024

Abstract

Patients with drug-resistant tuberculosis (DR-TB) who are treated with various DR-TB regimens are registered in the National Tuberculosis Information Program (NTIP) of Thailand by the hospitals providing care. This study aimed to evaluate the treatment outcomes of DR-TB patients registered in the national reporting system during fiscal years 2022-2024 (B.E. 2565-2567). The study was conducted as a cross-sectional research on the time to sputum culture conversion from positive to negative using survival analysis. Factors associated with treatment success were examined using the Chi-square test at a statistical significance level of 0.05. Statistically significant variables identified from the univariate analysis were further analyzed using multiple logistic regression. A total of 3,145 DR-TB patients were included. The majority were male (male-to-female ratio: 2.4:1.0). The largest number of patients were aged 41-50 years (21.84%), followed by 51-60 years (20.13%). Comorbidities included diabetes mellitus (10.46%) and HIV infection (12.66%). Treatment outcomes showed a success rate of 62.07%, with failure (1.81%), death (15.83%), loss to follow-up (8.81%), transfer-out (2.07%), and unevaluated outcomes (9.41%). Monitoring sputum culture conversion monthly for nine months revealed that the highest rate of conversion from positive to negative at month two was observed in patients receiving BPaLM regimen, followed by BPaL. These regimens were also associated with lower mortality and loss to follow-up compared to other regimens. Patients aged <60 years had 1.5 times higher odds of treatment success rate compared with those aged >60 years (AOR=1.50; 95% CI: 1.30-1.82). HIV-negative patients had 1.9 times higher odds of treatment success rate compared with HIV-postive patients (AOR=1.90; 95% CI: 1.57-2.42). In fiscal year 2024, 248 patients were still undergoing treatment and therefore could not be evaluated. Future research should aim to monitor and evaluate treatment outcomes among this ongoing patient cohort. Furthermore, cured DR-TB patients should undergo follow-up clinical assessments at 6 and 12 months post-treatment completion.