Factors Associated with Mortality from Multidrug-Resistant Tuberculosis in Kinshasa (2011-2018)

Introduction: Multidrug-resistant tuberculosis (MDR-TB) represents a serious threat to global tuberculosis control. In the Democratic Republic of Congo, few studies have been conducted to identify the factors associated with mortality. Methodology: This study examined the factors associated with mortality during the management of MDR-TB in Kinshasa, DRC. It was a cross-sectional analytical study of patients undergoing anti-tuberculosis treatment from January 1, 2011, to December 31, 2018, whose treatment outcomes were known. The study included 1806 MDR-TB cases, of which 233 resulted in death, through an exhaustive sampling method. Data were analyzed using SPSS 26, and multivariate analysis using multiple logistic regression identified the factors associated with mortality. Results: Among the 1806 cases included in the study, 233 (12.9%) died. The average age was 33.87 years (±13.06), ranging from 1 to 84 years, with a median age of 32 years. Among the deceased, 58.3% were male, with a sex ratio of 1.4; 12% were HIV coinfected, and 65% were on antiretroviral therapy, of whom 70.1% received the 9-month short regimen. The median time to treatment initiation was 13 days (IQR 22). Factors associated with mortality included HIV-positive status (p = 0.001), the 20-month long treatment regimen (p = 0.025), and the absence of antiretroviral therapy administration (p = 0.016). Conclusion: The mortality rate for MDR-TB remains high. The HIV-positive status, the 20-month long treatment regimen, and the lack of antiretroviral therapy were the key factors associated with MDR-TB mortality in Kinshasa. Timely treatment initiation and continuous patient monitoring are crucial strategies to reduce MDR-TB deaths. The emergence of multidrug-resistant pulmonary tuberculosis reflects deficiencies in the tuberculosis control program in Kinshasa.