Multidrug-resistant tuberculosis (MDR-TB) poses a significant public health challenge due to tuberculosis treatment mismanagement compounded by HIV coinfection. This study aimed to characterise the socio-demographic and clinical profiles of MDR-TB patients admitted to Lesotho’s Botšabelo MDR-TB Hospital between 2007 and 2016.

Utilising retrospective observational cohort methods, national data comprising 1 456 patient records from Lesotho’s MDR-TB referral hospital was analysed. The median age of participants was 39 years (IQR 31-50), with a male predominance of 62,6%. The majority (75,7%) were MDR-TB/HIV coinfected, and 29,1% succumbed to the disease. Among coinfected individuals, the median age was 38 years (IQR 32-47), with a higher prevalence of males (59,2%).

While 56,8% of coinfected patients were cured of TB, mortality rates were alarming, particularly in the initial treatment phase, underscoring the importance of vigilant monitoring throughout the therapy regimen. Treatment initiation saw a gradual increase from 2,9% in 2007 to a peak of 15,7% in 2016, with 56,3% of patients ultimately cured.

This study highlighted the elevated mortality risk in MDR-TB/HIV coinfected patients, necessitating enhanced care strategies especially during the early stages of treatment.