Multidrug resistant tuberculosis (MDR-TB) in Eritrea: a retrospective cohort analysis of mortality and associated factors (2013 - 2023).

Background: 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' clinical profile and outcomes in Eritrea. In particular, focus was directed at hemato-biochemical predictors of mortality. Methods: This study was a retrospective (2013-2023) 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. Results: The mean age (± Standard deviation (SD)) at enrolment was: 41.7 years (± 16.5), 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 Conclusion: 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.