Sociodemographic and Clinical Factors Associated with Treatment Outcomes for Drug-resistant Tuberculosis.

Autor: de Oliveira Jeronymo Neves AC; Medical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil., Gomes Dos Santos AP; Medical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil., de Medeiros RL; Medical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil., de Oliveira Jeronymo AJ; Federal University of Juiz de Fora, Minas Gerais, Brazil., Coelho Neves G; Federal University of Juiz de Fora, Minas Gerais, Brazil., de Almeida IN; Federal University of Ouro Preto, Minas Gerais, Brazil., Carvalho de Queiroz Mello F; Medical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil., Lineu Kritski A; Medical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Jazyk: angličtina
Zdroj: The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2022 Oct 31; Vol. 107 (6), pp. 1295-1301. Date of Electronic Publication: 2022 Oct 31 (Print Publication: 2022).
DOI: 10.4269/ajtmh.22-0294
Abstrakt: Drug-resistant tuberculosis (DR-TB) continues to be a serious public health problem. The objective of this study was to evaluate the sociodemographic, radiological, clinical, and outcome characteristics and assess the determinants of unfavorable outcomes in DR-TB. The descriptive-analytical study was carried out in a reference outpatient clinic in Rio de Janeiro, Brazil, among DR-TB cases that received treatment between February 2016 and October 2020, using descriptive statistics, χ2 test, and logistic regression multivariate. Of the 148 cases, 12.2% were resistant to rifampicin, 12.2% were resistant to isoniazid, 18.2% were polyresistant, 56.1% multidrug resistant, and 1.3% were extensively drug resistant. Most of the patients were men, aged up to 44 years, with brown or black skin, having up to 8 years of schooling, unemployed or working in the informal economy, and of low income. Presenting with acquired resistance or positive sputum smear microscopy in the diagnosis, taking more than four drugs, and being unemployed were associated with unfavorable outcomes. Having no income or acquired resistance doubled the chances of unfavorable outcomes. There was a high proportion of unfavorable outcomes, thereby highlighting the need to concentrate efforts on planning and executing public policies that include the severity of DR-TB and its risk factors.
Databáze: MEDLINE