Patient- and provider-related factors in the success of multidrug-resistant tuberculosis treatment in Colombia.

Autor:	Puerto Castro GM; Colombia National Network for Tuberculosis Research Innovation and Knowledge Management, National Institute of Health Bogotá Colombia Colombia National Network for Tuberculosis Research Innovation and Knowledge Management, National Institute of Health, Bogotá, Colombia., Montes Zuluaga FN; Medellín Municipal Secretariat of Health Medellín Colombia Medellín Municipal Secretariat of Health, Medellín, Colombia., Alcalde-Rabanal JE; Mexico National Institute of Public Health, Health Systems Research Center, Cuernavaca Morelos Mexico Mexico National Institute of Public Health, Health Systems Research Center, Cuernavaca, Morelos, Mexico., Pérez F; Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization Washington, DC USA Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization, Washington, DC, USA.
Jazyk:	angličtina
Zdroj:	Revista panamericana de salud publica = Pan American journal of public health [Rev Panam Salud Publica] 2021 Jun 21; Vol. 45, pp. e74. Date of Electronic Publication: 2021 Jun 21 (Print Publication: 2021).
DOI:	10.26633/RPSP.2021.74
Abstrakt:	Objective: To identify patient- and provider-related factors associated with the success of multidrug-resistant tuberculosis (MDR-TB) treatment in the six municipalities of Colombia with the highest number of MDR-TB cases. Methods: Bivariate and multivariate logistic regressions were used to analyze the association between treatment success (cure or treatment completion) and characteristics of the patients and physicians, nursing professionals, and psychologists involved in their treatment. The importance of knowledge in the management of MDR-TB cases was explored through focus groups with these providers. Results: Of 128 cases of TB-MDR, 63 (49.2%) experienced treatment success. Only 52.9% of the physicians and nursing professionals had satisfactory knowledge about MDR-TB. Logistic regression showed that being HIV negative, being affiliated with the contributory health insurance scheme, being cared for by a male physician, and being cared for by nursing professionals with sufficient knowledge were associated with a successful treatment outcome ( p ≤ 0.05). Qualitative analysis showed the need for in-depth, systematic training of health personnel who care for patients with MDR-TB. Conclusions: Some characteristics of patients and healthcare providers influence treatment success in MDR-TB cases. Physicians' and nurses' knowledge about MDR-TB must be improved, and follow-up of MDR-TB patients who are living with HIV and of those affiliated with the subsidized health insurance scheme in Colombia must be strengthened, as these patients have a lower likelihood of a successful treatment outcome.
Databáze:	MEDLINE
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