Pattern and predictors of drug resistance and treatment outcome in tuberculosis patients at the centers of programmatic management of drug-resistant tuberculosis in Lahore, Pakistan.
| Title: | Pattern and predictors of drug resistance and treatment outcome in tuberculosis patients at the centers of programmatic management of drug-resistant tuberculosis in Lahore, Pakistan. |
|---|---|
| Authors: | Ashfaq H; Public Health and Community Medicine Department, Shaikh Zayed Postgraduate Medical Institute, Lahore, Pakistan.; Humayun A; Public Health and Community Medicine Department, Shaikh Zayed Postgraduate Medical Institute, Lahore, Pakistan. drayeshah@gmail.com.; Naseem MA; Public Health and Community Medicine Department, Shaikh Zayed Postgraduate Medical Institute, Lahore, Pakistan.; Siddiqui SW; Oxford Policy Management Pakistan, Lahore, Pakistan.; Kamal A; Department of Statistics, Lahore College for Women University, Lahore, Pakistan.; Mohsin SN; NIH, HRI, Research Center NHRC, Shaikh Zayed Post Graduate Medical Institute, Lahore, Pakistan.; Abdullah M; HCA Florida Oak Hill Hospital, Brooksville, FL, USA.; Sheikh NH; Allama Iqbal Medical College, Lahore, Pakistan. |
| Source: | BMC public health [BMC Public Health] 2026 Feb 18; Vol. 26 (1). Date of Electronic Publication: 2026 Feb 18. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE; In Process |
| Imprint Name(s): | Original Publication: London : BioMed Central, [2001- |
| Competing Interests: | Declarations. Ethics approval and consent to participate: The study adhered to the principles of Helsinki’s declaration. Ethical approval was obtained from the IRB named Institutional Review and Research Advisory Board of Shaikh Zayed Postgraduate Medical Institute, Lahore, Pakistan. The secondary data were accessed so the need for consent was waived off by the IRB, so only permission and administrative consent were obtained from the program manager of the TB control program in Punjab, Pakistan. Consent for publication: Not applicable. Competing interests: Ex-manager TB control program, Punjab is one of the co-authors in this paper. |
| References: | Nakajima H. Tuberculosis: a global emergency. World Health. 1993;46(4):3–3.; Dye C, Garnett GP, Sleeman K, Williams BG. Prospects for worldwide tuberculosis control under the WHO DOTS strategy. Lancet. 1998;352(9144):1886–91. (PMID: 10.1016/S0140-6736(98)03199-79863786); Raviglione MC. The TB epidemic from 1992 to 2002. Tuberculosis. 2003;83(1–3):4–14. (PMID: 10.1016/S1472-9792(02)00071-912758183); Raviglione MC. The new stop TB strategy and the global plan to stop TB, 2006–2015. SciELO Public Health. 2007;85:327–327.; Organization WH. A regional response to the emerging threats of multidrug-resistant and extensively drug resistant tuberculosis. In.; 2009.; Raviglione MC, Pio A. Evolution of WHO policies for tuberculosis control, 1948–2001. Lancet. 2002;359(9308):775–80. (PMID: 10.1016/S0140-6736(02)07880-711888605); WHO. Global Tuberculosis Report 2022. 2022:68.; Organization WH. The global MDR-TB & XDR-TB response plan 2007–2008. In.: World Health Organization; 2007.; Mirzayev F, Viney K, Linh NN, Gonzalez-Angulo L, Gegia M, Jaramillo E, Zignol M, Kasaeva T. World health organization recommendations on the treatment of drug-resistant tuberculosis, 2020 update. Eur Respir J. 2021;57(6):2003300.; Organization WH. WHO consolidated guidelines on tuberculosis. Module 4: treatment-drug-resistant tuberculosis treatment, 2022 update. World Health Organization; 2022.; Lan Z, Ahmad N, Baghaei P, Barkane L, Benedetti A, Brode SK, Brust JC, Campbell JR, Chang VWL, Falzon D. Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet Respiratory Med. 2020;8(4):383–94. (PMID: 10.1016/S2213-2600(20)30047-3); Ahmad N, Ahuja SD, Akkerman OW, Alffenaar J-WC, Anderson LF, Baghaei P, Bang D, Barry PM, Bastos ML, Behera D. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet. 2018;392(10150):821–34. (PMID: 10.1016/S0140-6736(18)31644-1302153816463280); Glasauer S, Altmann D, Hauer B, Brodhun B, Haas W, Perumal N. First-line tuberculosis drug resistance patterns and associated risk factors in Germany, 2008–2017. PLoS ONE. 2019;14(6):e0217597. (PMID: 10.1371/journal.pone.0217597311888486561568); Ye M, Yuan W, Molaeipour L, Azizian K, Ahmadi A, Kouhsari E. Antibiotic heteroresistance in Mycobacterium tuberculosis isolates: a systematic review and meta-analysis. Ann Clin Microbiol Antimicrob. 2021;20(1):73. (PMID: 10.1186/s12941-021-00478-z346454638513340); Lecai J, Mijiti P, Chuangyue H, Mingzhen L, Qian G, Weiguo T, Jihong C. Predictors and trends of MDR/RR-TB in Shenzhen china: a retrospective 2012–2020 period analysis. Infect Drug Resist. 2021;14:4481. (PMID: 10.2147/IDR.S335329347375888558316); Tola H, Holakouie-Naieni K, Mansournia MA, Yaseri M, Gamtesa DF, Tesfaye E, Mahamed Z, Sisay MM. National treatment outcome and predictors of death and treatment failure in multidrug-resistant tuberculosis in ethiopia: a 10-year retrospective cohort study. BMJ Open. 2021;11(8):e040862. (PMID: 10.1136/bmjopen-2020-040862343764368356165); Atif M, Mukhtar S, Sarwar S, Naseem M, Malik I, Mushtaq A. Drug resistance patterns, treatment outcomes and factors affecting unfavourable treatment outcomes among extensively drug resistant tuberculosis patients in Pakistan; a multicentre record review. Saudi Pharm J. 2022;30(4):462–9. (PMID: 10.1016/j.jsps.2022.01.015355278269068524); van den Boom M, Bennani K, Sismanidis C, Gunneberg C, Khawaja L, Safdar MA, Muhwa C, Heldal E, Cirillo DM, Khan AW, et al. : 2022 TB programme review in pakistan: strengthening governance, with better patient diagnosis and treatment. IJTLD Open. 2024;1(3):136–43. (PMID: 10.5588/ijtldopen.23.05873896641111221579); Organization WH. Meeting report of the WHO expert consultation on the definition of extensively drug-resistant tuberculosis, 27–29 October 2020. 2021.; Salari N, Kanjoori AH, Hosseinian-Far A, Hasheminezhad R, Mansouri K, Mohammadi M. Global prevalence of drug-resistant tuberculosis: a systematic review and meta-analysis. Infect Dis Poverty. 2023;12(1):57. (PMID: 10.1186/s40249-023-01107-x3723146310210422); Bagcchi S. WHO’s global tuberculosis report 2022. Lancet Microbe. 2023;4(1):e20. (PMID: 10.1016/S2666-5247(22)00359-736521512); Javaid A, Khan MA, Afridi MZ, Khan AR, Ghafoor A. Prevalence and pattern of multidrug resistant tuberculosis among retreatment (Category II) patients of pulmonary tuberculosis in Khyber Pakhtunkhwa, Pakistan. Pakistan J Chest Med. 2020;26(3):121–7.; Chen Z, Wang T, Du J, Sun L, Wang G, Ni R, An Y, Fan X, Li Y, Guo R. Decoding the WHO global tuberculosis report 2024: a critical analysis of global and Chinese key data. Zoonoses. 2025;5(1):999. (PMID: 10.15212/ZOONOSES-2024-0061); Derashri G, Nayak S, Asati A, Marathe N, Jadhav T. Assessment of pattern of Drug-resistant TB and associated factors in Rewa, Madhya Pradesh, India. Epidemiol Health Syst J. 2022;9(1):34–9.; Akhtar AM, Arif MA, Kanwal S, Majeed S. Prevalence and drug resistance pattern of MDR TB in retreatment cases of Punjab, Pakistan. J Pak Med Assoc. 2016;66(8):989–983. (PMID: 27524534); Bhatti AI, Butt NI, Zahoor MA, Ashfaq F, Aftab S, Tareen MQ. Prevalence of MDR-TB in patients of pulmonary tuberculosis at a DHQ hospital. Pakistan J Med Res. 2022;61(2):52–5.; Oladimeji O, Othman Y, Oladimeji KE, Atiba BP, Adepoju VA, Odugbemi BA. Patterns of presentation of drug-resistant tuberculosis in nigeria: A retrospective file review. Microbiol Res. 2022;13(3):609–19. (PMID: 10.3390/microbiolres13030043); Jamil A, Aziz N, Zada I, Tarar AG, Qamber JH, Sheikh MU. Impact of treatment supporters on the treatment outcomes of drug Resistant-Tuberculosis patients. Pakistan J Chest Med. 2023;29(2):237–42.; Massud A, Khan AH, Syed Sulaiman SA, Ahmad N, Shafqat M, Ming LC. Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan. PLoS ONE. 2023;18(8):e0287966. (PMID: 10.1371/journal.pone.02879663756181010414635); Mughal MA, Imran A, Khan HU, Farooq M, Ikram A, Arshad F, Ashraf R, Khatoon F. Prevalence of Multidrug-Resistant tuberculosis and its association with previous treatment history in adults. Cureus. 2025;17(7):e88204.; Shibabaw A, Gelaw B, Gebreyes W, Robinson R, Wang S-H, Tessema B. The burden of pre-extensively and extensively drug-resistant tuberculosis among MDR-TB patients in the Amhara region, Ethiopia. PLoS ONE. 2020;15(2):e0229040. (PMID: 10.1371/journal.pone.0229040320536617018133); Abdul JBPAA, Adegbite BR, Ndanga MED, Edoa JR, Mevyann RC, Mfoumbi GRAI, De Dieu TJ, Mahoumbou J, Biyogho CM, Jeyaraj S. Resistance patterns among drug-resistant tuberculosis patients and trends-over-time analysis of National surveillance data in Gabon, central Africa. Infection. 2023;51(3):697–704. (PMID: 10.1007/s15010-022-01941-536307576); Johnson JM, Mohapatra AK, Velladath SU, Shettigar KS. Predictors of treatment outcomes in drug resistant Tuberculosis-Observational retrospective study. Int J Mycobacteriology. 2022;11(1):38–46. (PMID: 10.4103/ijmy.ijmy_244_21); Javaid A, Ullah I, Masud H, Basit A, Ahmad W, Butt Z, Qasim M. Predictors of poor treatment outcomes in multidrug-resistant tuberculosis patients: a retrospective cohort study. Clin Microbiol Infect. 2018;24(6):612–7. (PMID: 10.1016/j.cmi.2017.09.01228970158); Kibret KT, Moges Y, Memiah P, Biadgilign S. Treatment outcomes for multidrug-resistant tuberculosis under DOTS-Plus: a systematic review and meta-analysis of published studies. Infect Dis Poverty. 2017;6(1):7. (PMID: 10.1186/s40249-016-0214-x280930785240443); Zheng X-B, Diwan VK, Zhao Q, Hu Y, Bruchfeld J, Jiang W-L, Hoffner S, Xu B. Treatment quality and outcome for multidrug-resistant tuberculosis patients in four regions of china: a cohort study. Infect Dis Poverty. 2020;9(04):75–83.; Indarti HT, Kristin E, Soedarsono S, Endarti D. Treatment outcomes of Multidrug-Resistant tuberculosis patients in East Java, indonesia: A retrospective cohort analysis. Int J Mycobacteriology. 2022;11(3):261–7. (PMID: 10.4103/ijmy.ijmy_86_22); Yang TW, Park HO, Jang HN, Yang JH, Kim SH, Moon SH, Byun JH, Lee CE, Kim JW, Kang DH. Side effects associated with the treatment of multidrug-resistant tuberculosis at a tuberculosis referral hospital in South Korea: A retrospective study. Medicine. 2017;96(28):e7482.; Kwon BS, Kim Y, Lee SH, Lim SY, Lee YJ, Park JS, Cho Y-J, Yoon HI, Lee C-T, Lee JH. The high incidence of severe adverse events due to Pyrazinamide in elderly patients with tuberculosis. PLoS ONE. 2020;15(7):e0236109. (PMID: 10.1371/journal.pone.0236109326927747373258); Zhang Y, Wu S, Xia Y, Wang N, Zhou L, Wang J, Fang R, Sun F, Chen M, Zhan S. Adverse events associated with treatment of Multidrug-Resistant tuberculosis in china: an ambispective cohort study. Med Sci Monit. 2017;23:2348–56. (PMID: 10.12659/MSM.904682285207045444822); Atif M, Ahmed W, Nouman Iqbal M, Ahmad N, Ahmad W, Malik I, Al-Worafi YM. Frequency and factors associated with adverse events among Multi-Drug resistant tuberculosis patients in pakistan: A retrospective study. Front Med. 2022;8:790718. (PMID: 10.3389/fmed.2021.790718); Trébucq A, Schwoebel V, Kashongwe Z, Bakayoko A, Kuaban C, Noeske J, Hassane S, Souleymane B, Piubello A, Ciza F, et al. Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries. Int J Tuberc Lung Dis. 2018;22(1):17–25. (PMID: 10.5588/ijtld.17.049829149917); Alemu A, Bitew ZW, Worku T, Gamtesa DF, Alebel A. Predictors of mortality in patients with drug-resistant tuberculosis: A systematic review and meta-analysis. PLoS ONE. 2021;16(6):e0253848. (PMID: 10.1371/journal.pone.0253848341817018238236); Kliiman K, Altraja A. Predictors of extensively drug-resistant pulmonary tuberculosis. Ann Intern Med. 2009;150(11):766–75. (PMID: 10.7326/0003-4819-150-11-200906020-0000419487711); Abdullah M, Humayun A, Imran M, Bashir MA, Malik AA. A bibliometric analysis of global research performance on tuberculosis (2011–2020): time for a global approach to support high-burden countries. J Fam Commun Med. 2022;29(2):117. (PMID: 10.4103/jfcm.jfcm_112_22); Ou Z-J, Yu D-F, Liang Y-H, He W-Q, Li Y-Z, Meng Y-X, Xiong H-S, Zhang M-Y, He H, Gao Y-H. Trends in burden of multidrug-resistant tuberculosis in countries, regions, and worldwide from 1990 to 2017: results from the global burden of disease study. Infect Dis Poverty. 2021;10(1):1–10. (PMID: 10.1186/s40249-021-00803-w); Monedero-Recuero I, Gegia M, Wares DF, Chadha SS, Mirzayev F. Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape. Int J Infect Dis. 2021;108:557–67. (PMID: 10.1016/j.ijid.2021.06.02234139370) |
| Contributed Indexing: | Keywords: Adverse events; Drug resistance; Treatment outcomes; Tuberculosis; XDR |
| Entry Date(s): | Date Created: 20260219 Latest Revision: 20260328 |
| Update Code: | 20260409 |
| PubMed Central ID: | PMC13020006 |
| DOI: | 10.1186/s12889-026-26576-1 |
| PMID: | 41709251 |
| Database: | MEDLINE |
Journal Article