Abstract:
Introduction: Drug Resistant Tuberculosis (DR-TB) is a global public health threat that affects
thousands of people every year. The World Health Organization as per the Global tuberculosis
report 2018, reported that around 10 million fell ill in 2017, due to tuberculosis disease and among
them 558,000 people had drug resistant tuberculosis. This health status is associated with an
increasing risk of mortality, much greater while compared to the mortality in sensitive tuberculosis
patients. We aimed to assess mortality and risk factors in order to contribute to the reduction of
deaths among drug resistant tuberculosis patients in Rwanda.
Methods: Our study was a retrospective cohort design and we performed a data analysis using
Rwanda National Tuberculosis’s drug resistance tuberculosis excel database that includes patients
from July 2014 to December 2017. Socio-demographics and clinical follow up information were
collected using an established register at DR-TB centers then recorded electronically in excel
database at National Tuberculosis Program. We analyzed using Stata 13 software; bivariate and
multiple logistic regression were used to identify potential risk factors. P-values < 0.05 were
considered as statistically significant.
Results: Overall 279 DR-TB patients were enrolled in drug resistant tuberculosis (DR-TB) centers
from July 2014 to December 2017 and the male to female ratio being 2.3 (194/85). The mortality
rate in DR-TB patients found was 11.1% (31/279). Multivariate analysis showed that people ≥55
years old are 9 times more likely to die from DR-TB (AOR=9.7; 95%CI [1.19-20.59]), compared
to people ≤54 years old with DR-TB. Patients with DR-TB whose time to sputum conversion occur
after month two, are around 13 times at risk of death (AOR=13.1; 95% CI [2.9-29.1]), compared
to DR-TB patients that sputum converted before month 2.
Conclusion: Our study showed that male with DR-TB were double to female and age ≥55 years
old, time to sputum conversion occurring after month 2 being risk factors of death in DR-TB
patients. Special consideration is needed in management of the elderly patients with DR-TB and
those with sputum that do not convert within the first two months of treatment. These interventions
might reduce mortality among drug resistance tuberculosis patients in Rwanda.
