Impact of ethnic disparities on the treatment outcomes of HIV-negative drug-resistant tuberculosis patients in Kuala Lumpur, Malaysia: A call for a culturally-sensitive community intervention approach

Noorsuzana Mohd Shariff, Shamsul Azhar Shah, Fadzilah Kamaludin

Research output: Contribution to journalArticle

Abstract

Objective: Little is known about the treatment outcomes of HIV-negative drug-resistant tuberculosis (TB) patients in Malaysia. With respect to this issue, this study aimed to determine factors associated with unsuccessful treatment outcomes among drug-resistant TB patients at the Institute of Respiratory Medicine, Kuala Lumpur, Malaysia. Methods: This retrospective cohort study involved laboratory-confirmed drug-resistant TB patients from January 2009 to June 2013. Multiple logistic regression was used to model the outcome, which was subsequently defined according to the recent definition by the WHO. Data were analysed using IBM SPSS Statistics for Windows version 22.0. Results: Among the 403 patients who were analysed, 66.7% of them were found to have achieved successful outcomes (cured or completed treatment) while the remaining 33.3% had unsuccessful treatment outcomes (defaulted, treatment failure or died). Multivariable analysis showed that the type of resistance [polyresistant (aOR = 3.00, 95% CI 1.14–7.91), multidrug resistant (MDR) (aOR = 5.37, 95% CI 2.65–10.88)], ethnicity [Malay (aOR = 2.86, 95% CI 1.44–5.71), Indian (aOR = 3.04, 95% CI 1.20–7.70)], and treatment non-compliance (aOR = 26.93, 95% CI 14.47–50.10) were the independent risk factors for unsuccessful treatment outcomes among this group of patients. Notably, the odds of unsuccessful treatment outcome was also amplified among Malay MDR-TB patients in this study (aOR = 13.44, 95% CI 1.99–90.58). Conclusion: In order to achieve better treatment outcomes for TB, effective behavioural intervention and thorough investigation on ethnic disparities in TB treatment are needed to promote good compliance.

Original languageEnglish
Pages (from-to)274-279
Number of pages6
JournalJournal of Global Antimicrobial Resistance
Volume19
DOIs
Publication statusPublished - Dec 2019

Fingerprint

Multidrug-Resistant Tuberculosis
Malaysia
HIV
Tuberculosis
Pulmonary Medicine
Treatment Failure
Cohort Studies
Therapeutics
Retrospective Studies
Logistic Models

Keywords

  • Drug-resistant
  • Malaysia
  • Treatment outcome
  • Tuberculosis

ASJC Scopus subject areas

  • Microbiology
  • Immunology and Allergy
  • Immunology
  • Microbiology (medical)

Cite this

@article{97a8941e4de74afbba72b45ff62db86e,
title = "Impact of ethnic disparities on the treatment outcomes of HIV-negative drug-resistant tuberculosis patients in Kuala Lumpur, Malaysia: A call for a culturally-sensitive community intervention approach",
abstract = "Objective: Little is known about the treatment outcomes of HIV-negative drug-resistant tuberculosis (TB) patients in Malaysia. With respect to this issue, this study aimed to determine factors associated with unsuccessful treatment outcomes among drug-resistant TB patients at the Institute of Respiratory Medicine, Kuala Lumpur, Malaysia. Methods: This retrospective cohort study involved laboratory-confirmed drug-resistant TB patients from January 2009 to June 2013. Multiple logistic regression was used to model the outcome, which was subsequently defined according to the recent definition by the WHO. Data were analysed using IBM SPSS Statistics for Windows version 22.0. Results: Among the 403 patients who were analysed, 66.7{\%} of them were found to have achieved successful outcomes (cured or completed treatment) while the remaining 33.3{\%} had unsuccessful treatment outcomes (defaulted, treatment failure or died). Multivariable analysis showed that the type of resistance [polyresistant (aOR = 3.00, 95{\%} CI 1.14–7.91), multidrug resistant (MDR) (aOR = 5.37, 95{\%} CI 2.65–10.88)], ethnicity [Malay (aOR = 2.86, 95{\%} CI 1.44–5.71), Indian (aOR = 3.04, 95{\%} CI 1.20–7.70)], and treatment non-compliance (aOR = 26.93, 95{\%} CI 14.47–50.10) were the independent risk factors for unsuccessful treatment outcomes among this group of patients. Notably, the odds of unsuccessful treatment outcome was also amplified among Malay MDR-TB patients in this study (aOR = 13.44, 95{\%} CI 1.99–90.58). Conclusion: In order to achieve better treatment outcomes for TB, effective behavioural intervention and thorough investigation on ethnic disparities in TB treatment are needed to promote good compliance.",
keywords = "Drug-resistant, Malaysia, Treatment outcome, Tuberculosis",
author = "Shariff, {Noorsuzana Mohd} and Shah, {Shamsul Azhar} and Fadzilah Kamaludin",
year = "2019",
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doi = "10.1016/j.jgar.2019.05.009",
language = "English",
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pages = "274--279",
journal = "Journal of Global Antimicrobial Resistance",
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T1 - Impact of ethnic disparities on the treatment outcomes of HIV-negative drug-resistant tuberculosis patients in Kuala Lumpur, Malaysia

T2 - A call for a culturally-sensitive community intervention approach

AU - Shariff, Noorsuzana Mohd

AU - Shah, Shamsul Azhar

AU - Kamaludin, Fadzilah

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N2 - Objective: Little is known about the treatment outcomes of HIV-negative drug-resistant tuberculosis (TB) patients in Malaysia. With respect to this issue, this study aimed to determine factors associated with unsuccessful treatment outcomes among drug-resistant TB patients at the Institute of Respiratory Medicine, Kuala Lumpur, Malaysia. Methods: This retrospective cohort study involved laboratory-confirmed drug-resistant TB patients from January 2009 to June 2013. Multiple logistic regression was used to model the outcome, which was subsequently defined according to the recent definition by the WHO. Data were analysed using IBM SPSS Statistics for Windows version 22.0. Results: Among the 403 patients who were analysed, 66.7% of them were found to have achieved successful outcomes (cured or completed treatment) while the remaining 33.3% had unsuccessful treatment outcomes (defaulted, treatment failure or died). Multivariable analysis showed that the type of resistance [polyresistant (aOR = 3.00, 95% CI 1.14–7.91), multidrug resistant (MDR) (aOR = 5.37, 95% CI 2.65–10.88)], ethnicity [Malay (aOR = 2.86, 95% CI 1.44–5.71), Indian (aOR = 3.04, 95% CI 1.20–7.70)], and treatment non-compliance (aOR = 26.93, 95% CI 14.47–50.10) were the independent risk factors for unsuccessful treatment outcomes among this group of patients. Notably, the odds of unsuccessful treatment outcome was also amplified among Malay MDR-TB patients in this study (aOR = 13.44, 95% CI 1.99–90.58). Conclusion: In order to achieve better treatment outcomes for TB, effective behavioural intervention and thorough investigation on ethnic disparities in TB treatment are needed to promote good compliance.

AB - Objective: Little is known about the treatment outcomes of HIV-negative drug-resistant tuberculosis (TB) patients in Malaysia. With respect to this issue, this study aimed to determine factors associated with unsuccessful treatment outcomes among drug-resistant TB patients at the Institute of Respiratory Medicine, Kuala Lumpur, Malaysia. Methods: This retrospective cohort study involved laboratory-confirmed drug-resistant TB patients from January 2009 to June 2013. Multiple logistic regression was used to model the outcome, which was subsequently defined according to the recent definition by the WHO. Data were analysed using IBM SPSS Statistics for Windows version 22.0. Results: Among the 403 patients who were analysed, 66.7% of them were found to have achieved successful outcomes (cured or completed treatment) while the remaining 33.3% had unsuccessful treatment outcomes (defaulted, treatment failure or died). Multivariable analysis showed that the type of resistance [polyresistant (aOR = 3.00, 95% CI 1.14–7.91), multidrug resistant (MDR) (aOR = 5.37, 95% CI 2.65–10.88)], ethnicity [Malay (aOR = 2.86, 95% CI 1.44–5.71), Indian (aOR = 3.04, 95% CI 1.20–7.70)], and treatment non-compliance (aOR = 26.93, 95% CI 14.47–50.10) were the independent risk factors for unsuccessful treatment outcomes among this group of patients. Notably, the odds of unsuccessful treatment outcome was also amplified among Malay MDR-TB patients in this study (aOR = 13.44, 95% CI 1.99–90.58). Conclusion: In order to achieve better treatment outcomes for TB, effective behavioural intervention and thorough investigation on ethnic disparities in TB treatment are needed to promote good compliance.

KW - Drug-resistant

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