{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:36:32Z","timestamp":1792092992352,"version":"4.4.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Globally, multidrug-resistant tuberculosis (MDR-TB) is a major public health problem. The tuberculosis rate in Sierra Leone is 298 per 100,000 people, and Sierra Leone is considered a country with a high burden of tuberculosis. In Sierra Leone, there are few studies on the outcomes of MDR-TB treatment, especially those exacerbated by COVID-19. We identified factors associated with unfavorable treatment outcomes among people with MDR-TB in Sierra Leone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study to analyze hospital-based MDR-TB data from 2017 to 2021. Demographic, clinical, and treatment outcome data were extracted from the main MDR-TB referral hospital database. We defined unfavorable outcomes as patients who died, were lost to follow-up, or defaulted. We calculated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to identify predictors of the outcomes of MDR-TB treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 2017 and 2021, 628 people with MDR-TB were reported at Lakka Hospital; 441 (71%) were male, with a median age of 25 years (interquartile ranges: 17\u201334). Clinically, 21% of the 628 MDR-TB patients were HIV positive, and 413 were underweight (66%). 70% (440) of MDR-TB patients received tuberculosis treatment. The majority of patients, 457 (73%), were treated with a short treatment regimen, and 126 (20%) experienced unfavorable outcomes. Age 45 years or younger (aOR\u2009=\u20095.08; CI:1.87\u201313.82), 21\u201345 years (aOR\u2009=\u20092.22; CI:140\u20133.54), tuberculosis retreatment (aOR\u2009=\u20093.23; CI:1.82\u20135.73), age group, HIV status (aOR\u2009=\u20092.16; CI:1.33\u20133.53), and malnourishment status (aOR\u2009=\u20091.79; CI:1.12\u20132.86) were significantly associated with unfavorable treatment outcomes for DR-TB patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This analysis revealed a high proportion of unfavorable treatment outcomes among MDR-TB patients in Sierra Leone. Malnourishment, TB retreatment, HIV coinfection, and age 45 years or younger were associated with unfavorable outcomes of MDR-TB treatment. Increasing patients\u2019 awareness, mainly among young people, heightens treatment adherence and HIV monitoring by measuring the amount of HIV in patient blood, which can reduce adverse treatment outcomes in Sierra Leone and other sub-Saharan African countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-024-09370-5","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T13:02:17Z","timestamp":1718110937000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Factors associated with unfavorable treatment outcomes among multidrug-resistant tuberculosis patients, Sierra Leone: a cross-sectional secondary data analysis"],"prefix":"10.1186","volume":"24","author":[{"given":"Josephine Amie","family":"Koroma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel Hussein","family":"Elduma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umaru","family":"Sesay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gebrekrstos Negash","family":"Gebru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"9370_CR1","unstructured":"Centers for Disease Control and Prevention [Internet]. 2016 [cited 2023 May 24]. 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[cited 2024 Feb 20]. https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/tb-reports\/global-tuberculosis-report-2023\/tb-disease-burden\/1-3-drug-resistant-tb."},{"key":"9370_CR5","unstructured":"Medicine (US). I of. Drug-Resistant TB in India. In: Facing the Reality of Drug-Resistant Tuberculosis in India: Challenges and Potential Solutions: Summary of a Joint Workshop by the Institute of Medicine, the Indian National Science Academy, and the Indian Council of Medical Research [Internet]. National Academies Press (US); 2012 [cited 2023 May 24]. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK100386\/."},{"key":"9370_CR6","unstructured":"2.3 Drug. -resistant TB [Internet]. 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This publication analyzed the Multidrug-Resistant Tuberculosis secondary dataset after obtaining permission from the National Tuberculosis Control Program. dataset was collected from the multidrug-resistant tuberculosis registry. The publication does not compromise anonymity or confidentiality or breach local data protection laws. The dataset did not contain any direct or indirect identifiers. In this study, a multidrug-resistant tuberculosis secondary dataset from the National Tuberculosis Program was used. All patient records were anonymous, and any identifiable information was removed from the final analysis to maintain patient confidentiality. All methods we followed in this secondary data collection were performed in accordance with ethical guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"This study is not applicable because the manuscript does not include individual details, images, or videos related to individuals.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"579"}}