Patterns of Drug Resistance Tuberculosis and Predictors of Treatment Outcomes: A Retrospective Study Among Patients in Selected Health Facilities in Benue State

Abstract

Drug-resistant tuberculosis (DR-TB) remains a major public health challenge globally and in Nigeria, undermining tuberculosis (TB) control efforts. Benue State has recorded increasing cases of multidrug-resistant TB (MDR-TB) and rifampicin-resistant TB (RR-TB), with implications for treatment outcomes. The aim of this study was to determine the pattern of drug resistance and predictors of treatment outcomes among DR-TB patients managed in selected treatment centers in Benue State. This study was a retrospective review of 310 DR-TB patient records registered between January 2019 and December 2022 which was conducted across three treatment centers in Benue State. Data were extracted on sociodemographic characteristics, resistance patterns, HIV status, patient category, and treatment outcomes. Diagnosis was based on GeneXpert MTB/RIF, sputum culture, and line probe assay (LPA). Data were analyzed using SPSS version 23. Chi-square tests and logistic regression were performed at a 95% confidence interval, with p ≤ 0.05 considered statistically significant. Results showed that majority of patients were aged >15 years (98.7%), male (71.9%), rural residents (63.9%), and farmers (43.2%). MDR-TB constituted 71.2% of resistance patterns, followed by RR-TB (19.7%), pre-XDR-TB (4.9%), and mono-resistance (4.2%). Treatment success was achieved in 87.1% of patients. Formal education (AOR=5.2; 95% CI: 1.5–18.1), new patient category (AOR=15.6; 95% CI: 6.5–37.5), and HIV-negative status were significant predictors of successful outcomes. In conclusion, MDR-TB is the predominant resistance pattern in Benue State, with relatively high treatment success rates. Educational status, HIV co-infection, and previous TB treatment significantly influence outcomes. Strengthening early diagnosis, adherence support, and TB–collaborative care is essential.