Background & objectives: The increase in the burden of multidrug-resistant tuberculosis (MDR-TB) is a matter of grave concern. The present study was undertaken to describe MDR-TB treatment outcome trends in Delhi and their epidemiological correlates, to assess the adequacy of treatment records and to also generate evidence towards influencing and improving practices related to the MDR-TB control programme.
Methods: A retrospective record-based study (2009-2014) was conducted in three major drug resistance TB treatment centres of Delhi. Treatment outcomes and adverse effects were extracted from the existing programme records including patients' treatment cards and laboratory registers.
Results: A total of 2958 MDR-TB patients were identified from the treatment cards, of whom 1749 (59.12%) were males. The mean (±standard deviation) age was 30.56±13.5 years. Favourable treatment outcomes were reported in 1371 (53.28%) patients, but they showed a declining trend during the period of observation. On binomial logistic regression analysis, patients with age ≥35 yr, male sex and undernourishment (body mass index <18.5) at the time of treatment initiation had a significantly increased likelihood of unfavourable MDR-TB treatment outcome (P <0.001).
Interpretation & conclusions: The study showed an increasing burden of MDR-TB patients, especially in the young population with increased risk of transmission posing a major challenge in achieving TB elimination targets.


中文翻译：

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印度德里的多药耐药结核病的趋势和治疗结局（2009-2014年）：一项基于记录的回顾性研究。


背景与目标：耐多药结核病（MDR-TB）负担的增加是一个令人严重关注的问题。进行本研究是为了描述德里的耐多药结核病治疗结果趋势及其流行病学相关性，评估治疗记录的充分性，并为影响和改善与耐多药结核病控制计划有关的实践提供证据。
方法：在德里的三个主要耐药结核病治疗中心进行了一项基于回顾性记录的研究（2009-2014年）。从现有的计划记录中提取治疗结果和不良反应，包括患者的治疗卡和实验室记录。
结果：从治疗卡中总共鉴定出2958例耐多药结核病患者，其中1749例（59.12％）为男性。平均年龄（±标准差）为30.56±13.5岁。据报告有1371名患者（53.28％）的治疗结局良好，但在观察期间呈下降趋势。根据二项式logistic回归分析，开始治疗时年龄≥35岁，男性和营养不良（体重指数<18.5）的患者发生不良耐多药结核病治疗结果的可能性显着增加（P <0.001）。
解释与结论：该研究表明，耐多药结核病患者的负担增加，尤其是在年轻人中，传播风险增加，这对实现结核病消除目标构成了重大挑战。