{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:59:34Z","timestamp":1793642374310,"version":"4.5.1"},"reference-count":47,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Malaysian Association for Prevention of Tuberculosis","award":["MAPTB\/N\/GAB\/111904"],"award-info":[{"award-number":["MAPTB\/N\/GAB\/111904"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,23]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The emergence of drug-resistant tuberculosis (DR-TB) complicates TB management and poses significant challenges to achieve favourable treatment outcomes. Treating DR-TB is more complex and costly, requiring extended treatment durations and consideration of drug toxicity and side effects. This study aims to identify the determinants of unfavourable treatment outcomes among DR-TB patients in Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective case\u2013control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Secondary data from the National Tuberculosis Registry (NTBR) across two states in Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All reported DR-TB cases in the NTBR between 2016 and 2020 from Selangor and Wilayah Persekutuan Kuala Lumpur, Malaysia. Cases still undergoing treatment at the time of analysis were excluded. A total of 403 cases were analysed, with 181 (44.9%) experiencing unfavourable treatment outcomes and 222 (55.1%) having favourable treatment outcomes. The case group consists of individuals with DR-TB who experienced unfavourable treatment outcomes, while the control group comprises individuals with DR-TB who achieved favourable treatment outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Unfavourable treatment outcomes, defined as death, treatment failure or loss to follow-up, were assessed. Predictors of these outcomes were identified through multiple logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant determinants of unfavourable treatment outcomes included being male (adjusted OR (aOR) 2.38, 95%\u2009CI 1.44 to 3.94), being single or divorced (aOR 1.61, 95%\u2009CI 1.03 to 2.49), having no formal education (aOR 3.09, 95%\u2009CI 1.49 to 6.41), people living with HIV (aOR 2.87, 95%\u2009CI 1.40 to 5.87) and having DR-TB categorised as rifampicin-resistant tuberculosis (aOR 3.34, 95%\u2009CI 1.90 to 5.86) or multidrug-resistant\/pre-extensively drug-resistant\/extensively drug-resistant-TB (aOR 2.57, 95%\u2009CI 1.52 to 4.33).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings reveal a high proportion of DR-TB cases with unfavourable treatment outcomes and identify their key determinants. Targeted interventions addressing these factors are essential to improve treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-093391","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T20:21:18Z","timestamp":1739910078000},"page":"e093391","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Determinants of unfavourable treatment outcomes of drug-resistant tuberculosis cases in Malaysia: a case\u2013control study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0279-971X","authenticated-orcid":false,"given":"Mohd Fahmin","family":"Kamarul Zaman","sequence":"first","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6798-0838","authenticated-orcid":false,"given":"Nik Rosmawati","family":"Nik Husain","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4941-0428","authenticated-orcid":false,"given":"Mohd Yusof","family":"Sidek","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zamzurina","family":"Abu Bakar","sequence":"additional","affiliation":[{"name":"Institute of Respiratory Medicine, Hospital Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"2025081403364926000_15.2.e093391.1","unstructured":"World Health Organization . Implementing the end TB strategy. Available: https:\/\/www.who.int\/westernpacific\/activities\/implementing-the-end-tb-strategy#:~:text=%C2%A9-Overview,global%20TB%20epidemic%E2%80%9D%20by%202035 [Accessed 23 Oct 2022]."},{"key":"2025081403364926000_15.2.e093391.2","unstructured":"World Health Organization . Global tuberculosis report 2024. Available: https:\/\/iris.who.int\/bitstream\/handle\/10665\/379339\/9789240101531-eng.pdf?sequence=1 [Accessed 23 Dec 2022]."},{"key":"2025081403364926000_15.2.e093391.3","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00753-16"},{"key":"2025081403364926000_15.2.e093391.4","unstructured":"World Health Organization . Global tuberculosis report 2021. Available: https:\/\/www.who.int\/publications\/i\/item\/9789240037021 [Accessed 25 Oct 2022]."},{"key":"2025081403364926000_15.2.e093391.5","unstructured":"World Health Organization . Meeting report of the WHO expert consultation on the definition of extensively drug-resistant tuberculosis. 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