Multi-centre analysis of predictors of death and treatment failure among multi-drug-resistant tuberculosis patients in Pakistan.

Our Multidrug-resistant tuberculosis poses a significant global health challenge, particularly in low- and middle-income countries where access to diagnostic and treatment services is limited. Our multi-centre retrospective cohort study attempts to evaluate treatment outcomes and predictors of death or failure among 546 multi-drug-resistant tuberculosis patients, treated at eight specialised units between January 2017 and August 2018, with follow-up until June 2020. Overall, 69% achieved successful outcomes and 22.2% died. Significant predictors of death included older age, weight <40 kg, prior vitamin D use, and delayed sputum conversion. Despite outcomes nearing World Health Organisation targets, older patients and those with prior second-line drug exposure require closer monitoring.