{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:03:47Z","timestamp":1784527427307,"version":"3.55.0"},"reference-count":66,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multi-drug resistant tuberculosis (MDR-TB) continues to be a pressing global health concern, indiscriminate of country border and defined by higher mortality and higher treatment costs. Here, we sought to describe the MDR\/RR-TB patients\u2019 clinical profile and outcomes in Eritrea. In particular, focus was directed at hemato-biochemical predictors of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a retrospective (2013\u20132023) analysis of patients records at the Merhano MDR\/RR-TB hospital in Asmara, Eritrea. In total, records from 257 patients were reviewed. Data on treatment outcomes, hematological, biochemical and demographic characteristics was subsequently abstracted using a structured check-list. We incorporated Kaplan-Meier curve and multivariate Cox regression model to evaluate the relationship between covariates and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age (\u00b1\u00a0Standard deviation (SD)) at enrolment was: 41.7 years (\u00b1\u00a016.5), and the number of males in the cohort was 157(61.1%). Of all patients, 91(37.80%) had anemia (severe anemia, 18(7.5%); 205(79.8%) experienced adverse drug reaction (ADR); 30 (12.1%) had HIV; 45 (20.4%) had eGFR\n                      <jats:sub>Creat<\/jats:sub>\n                      &amp;lt; 60 mL\/min; 27(11.6%) had elevated BUN; 33(14.5%) had APRI score &amp;gt; 0.5; 45(21.6%) had hypothyroidism; 14 (5.9%) had thrombocytopenia; and 126(53.4%) had thrombocytosis. During treatment, 162 (63.0%, 95% CI: 57 \u2013 69.6%) patients were cured, 45(17.5%, 95% CI: 13.5 \u2013 22.0%) completed treatment, 40 (15.6%, 95% CI: 10.5-19.4%) died, and 8(3.1%, 95% CI: 1.2 \u2013 5.1%) were Lost to follow up. Median (IQR) time to death was 33 days (10\u2013130 days). After 137\u2013321 person days follow up (PDFU), the incidence of death (95% CI) was 2.91(2.11 \u2013 4.11) per 10\u2013000 PDFU. Predictors of mortality included age &amp;gt;60 years; Weight &amp;lt;30 Kg at baseline; Thrombocytopenia; Severe anemia; APRI score &amp;gt; 0.5; Hypothyroidism; elevated BUN, high serum creatinine (SCr) levels; and eGFR\n                      <jats:sub>Creat<\/jats:sub>\n                      &amp;lt; 60 mL\/min. In the multivariate Cox regression model, a unit increase in hemoglobin concentration and weight reduced the risk of death by 0.79(95% CI: 0.67 \u2013 0.93), P\u00a0=\u00a00.005 and 0.96(95% CI: 0.91-1.01), respectively. Further, higher likelihood of death was associated with elevated SCr (&amp;gt;12 mg\/dL) levels (aHR = 6.33 (95% CI: 2.33 \u2013 17.19), P&amp;lt;0.001, and APRI Score &amp;gt;0.5 (aHR = 2.78(95% CI: 1.65 \u2013 4.70), P&amp;lt;0.001. In contrast, a unit increase in age increased the risk of death (aHR = 1.045(95 CI%: 1.02 \u2013 1.07), P&amp;lt;0.001.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The magnitude of death and other unfavorable treatment outcome for MDR\/RR-TB was low. Of greater concern, however, was the critical condition of patients at presentation. Proactive strategies are needed to improve early detection of MDR\/RR-TB and supportive care in patients with severe complications. In addition, additional research on MDR\/TB-mortality is needed, especially among vulnerable subpopulations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1793864","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:35:51Z","timestamp":1784525751000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidrug resistant tuberculosis (MDR-TB) in Eritrea: a retrospective cohort analysis of mortality and associated factors (2013 \u2013 2023)"],"prefix":"10.3389","volume":"16","author":[{"given":"Hagos Andom","family":"Teumezgi","sequence":"first","affiliation":[{"name":"Research Unit, National Health Laboratory, Ministry of Health (MOH)","place":["Asmara, Eritrea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesredin Nuru","family":"Suud","sequence":"additional","affiliation":[{"name":"National Tuberculosis (TB) reference Laboratory, National Health Laboratory, Ministry of Health (MOH)","place":["Asmara, Eritrea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohannes Mehari","family":"Berhane","sequence":"additional","affiliation":[{"name":"National Tuberculosis (TB) reference Laboratory, National Health Laboratory, Ministry of Health (MOH)","place":["Asmara, Eritrea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleh Mohammed","family":"Said","sequence":"additional","affiliation":[{"name":"National Health Laboratory, Ministry of Health (MOH)","place":["Asmara, Eritrea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Tesfagherghish","family":"Hailu","sequence":"additional","affiliation":[{"name":"National Tuberculosis (TB) reference Laboratory, National Health Laboratory, Ministry of Health (MOH)","place":["Asmara, Eritrea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kidane Kifle","family":"Habtetsion","sequence":"additional","affiliation":[{"name":"National Tuberculosis (TB) reference Laboratory, National Health Laboratory, Ministry of Health (MOH)","place":["Asmara, Eritrea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tekie Merawi","family":"Weldetnsae","sequence":"additional","affiliation":[{"name":"National Tuberculosis (TB) reference Laboratory, National Health Laboratory, Ministry of Health (MOH)","place":["Asmara, Eritrea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver Okoth","family":"Achila","sequence":"additional","affiliation":[{"name":"Unit of Clinical Laboratory Sciences, Orotta College of Medicine and Health Sciences","place":["Asmara, Eritrea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"B51","doi-asserted-by":"publisher","first-page":"574951","DOI":"10.1155\/2018\/5740951","article-title":"Hematological abnormalities of pulmonary tuberculosis patients with and without HIV at the University of Gondar Hospital, Northwest Ethiopia: A comparative cross-sectional study","volume":"2018","author":"Abay","year":"2018","journal-title":"Tuberculosis Res. 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