article · Discover Public Health
Multidrug-resistant tuberculosis demands long and complex treatment regimens that carry frequent adverse effects, causing treatment interruption to threaten recovery and increase transmission risks. An observational case-control study at Saint Peter Specialized Hospital in Addis Ababa examined 267 patients treated between 2020 and 2024 to identify drivers of treatment interruption. Patients who missed at least one dose for a day up to two months were compared with those completing therapy without interruption. The findings reveal that male patients, individuals living with HIV, and those with a history of alcohol consumption faced substantially higher odds of interrupting their treatment. Conversely, patients who received a bacteriological diagnosis rather than a clinical diagnosis were significantly less likely to pause therapy. Addressing these specific vulnerability factors through tailored adherence support, integrated clinical care, and expanded bacteriological testing can assist healthcare services in keeping patients on life-saving therapy.
Treating multidrug-resistant tuberculosis requires strict adherence over long periods. When patients stop taking their medications, the risk of disease transmission, drug resistance, and death rises significantly. Pinpointing which patient groups are most prone to missed doses enables healthcare providers to target adherence support, integrate medical services, and reduce preventable treatment failures in specialised tuberculosis centres.
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Multidrug-resistant tuberculosis (MDR-TB) requires prolonged, complex regimens frequently associated with substantial adverse effects, making treatment interruption a major barrier to successful outcomes. Interruption may increase the risk of mortality, acquired drug resistance, and ongoing transmission. Evidence on factors associated with treatment interruption among MDR-TB patients in Ethiopia remains limited, particularly at specialized referral centers. This study aimed to identify factors associated with treatment interruption among patients receiving MDR-TB treatment at Saint Peter Specialized Hospital (SPSH), Addis Ababa, Ethiopia. We conducted a hospital-based, census-based observational study using an unmatched case-control analytic approach at Saint Peter Specialized Hospital. All eligible MDR-TB patients registered over five years (2020–2024) were considered for inclusion. A total of 267 participants (53 cases, 214 controls) were enrolled. Cases were patients who missed at least one prescribed dose for at least one day but less than two consecutive months; controls completed treatment as prescribed without such interruption. Data were collected via structured interviews and medical-record review using KoboToolbox and analyzed in Stata 14.0. Variables with p ≤ 0.25 in bivariate analysis were entered into multivariable logistic regression; associations are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI), with significance set at p < 0.05. Of 343 patients registered during the study period, 285 were eligible, and 267 were analyzed (53 cases and 214 controls). In multivariable analysis, HIV co-infection (AOR = 3.90; 95% CI: 1.45–10.50), history of alcohol consumption (AOR = 3.32; 95% CI: 1.50–7.30), and male sex (AOR = 2.89; 95% CI: 1.28–6.50) were associated with higher odds of treatment interruption, while bacteriological (versus clinical) diagnosis was associated with lower odds (AOR = 0.29; 95% CI: 0.12–0.67). In this study, HIV co-infection, male sex, and alcohol consumption were associated with higher odds of treatment interruption, whereas bacteriologically confirmed diagnosis was associated with lower odds. Strengthening integrated TB–HIV care, addressing alcohol use, implementing sex-responsive adherence interventions, and expanding access to bacteriological diagnosis may help reduce treatment interruption and improve MDR-TB outcomes in Ethiopia.
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DOI: 10.1186/s12982-026-02808-y
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