Association of the clinico-demographic and laboratory profile with treatment outcomes in patients with drug-resistant pulmonary tuberculosis

Background: Drug-resistant tuberculosis (DR-TB) is a significant public health problem, especially in the developing and underdeveloped countries; its treatment is relatively expensive, of longer duration, and associated with more adverse effects. Objective: The objective of this study was to report the treatment outcomes in patients with DR-TB and determine if a few selected clinico-demographic parameters and baseline laboratory values, done as part of the pre-treatment evaluation, have any impact on sputum culture conversion and outcomes. The aim was to identify the potential factors associated with unfavourable outcomes prior to starting the treatment. Methods: A retrospective analysis of data of patients diagnosed with DR-TB admitted at our centre from January 2015 to May 2016 was done. Of the 114 patients included, culture reports were available in 85 and 72 patients at the end of the third and sixth month, respectively. The clinico-demographic and laboratory parameters were compared with the sputum culture report at the end of the third and sixth month and final treatment outcomes. Results: Favorable outcome (cured) was seen in 33.3% (38/114) patients. Female gender was associated with delayed sputum culture conversion at three months (P = 0.020). A positive culture at the end of the sixth month was significantly associated with unfavourable outcomes (P = 0.002). A low body mass index (BMI) (15.86 [IQR, 14.10-18.11]) and a higher platelet count (358 × 10⁹/L [IQR, 282-4.85]) at the initiation of treatment were independently and significantly associated with unfavorable outcomes. Conclusion: Patients with a low BMI and high platelet count are more likely to have unfavourable treatment outcomes. Identifying patients with these risk factors during the pre-treatment phase, more intensive follow-up during the treatment course could be advocated.