Treatment outcomes and predictors of success for multidrug resistant tuberculosis MDR TB in Ugandan regional referral hospitals

Multidrug-resistant tuberculosis (MDR-TB) is a form of tuberculosis caused by strains resistant to both isoniazid and rifampicin, the most critical first-line drugs. Managing MDR-TB presents substantial challenges due to prolonged and costly treatment regimens, which are less effective than those for drug-susceptible TB. These difficulties are further exacerbated in low-resource settings by inadequate healthcare infrastructure, limited diagnostic capacity, and suboptimal access to treatment. Uganda, a high-burden TB country, faces persistent challenges in meeting national MDR-TB treatment targets, with high mortality rates and unfavourable outcomes. This study evaluated the treatment outcomes and factors associated with success among MDR-TB patients in regional referral hospitals. Of the 293 registered patients, 284 were included in the analysis, with a median age of 38 years (IQR: 30-45) and a predominance of male patients (65.1%). Overall, 68.7% of patients achieved successful treatment outcomes, while 31.3% experienced unfavourable outcomes. Multivariate analysis identified weight at treatment initiation (41-49 kg) as significantly associated with poor outcomes. These findings highlight a treatment success rate below national targets, with persistent high mortality and treatment failure in several regions. Addressing these challenges requires the development of innovative therapies and personalized care strategies to improve MDR-TB management in Uganda.