Impact of smoking on sputum culture conversion and pulmonary tuberculosis treatment outcomes in Brazil: a retrospective cohort study

Autor: Cailleaux-Cezar, Michelle, Loredo, Carla, Silva, José Roberto Lapa e, Conde, Marcus Barreto
Rok vydání: 2018
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Time Factors
Tuberculosis
Antitubercular Agents
Risk Assessment
Sputum culture
Mycobacterium tuberculosis
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Hábito de fumar
medicine
Tuberculose
Humans
030212 general & internal medicine
Treatment outcome
Tuberculosis
Pulmonary
Retrospective Studies
lcsh:RC705-779
biology
medicine.diagnostic_test
business.industry
Incidence (epidemiology)
Smoking
Sputum
Retrospective cohort study
lcsh:Diseases of the respiratory system
Middle Aged
biology.organism_classification
medicine.disease
3. Good health
Resultado do tratamento
Treatment Outcome
030228 respiratory system
Relative risk
Multivariate Analysis
Original Article
Female
medicine.symptom
Risk assessment
business
Brazil
Zdroj: Jornal Brasileiro de Pneumologia
Jornal Brasileiro de Pneumologia, Volume: 44, Issue: 2, Pages: 105-99, Published: APR 2018
Jornal Brasileiro de Pneumologia, Vol 44, Iss 2, Pp 99-105
Jornal Brasileiro de Pneumologia v.44 n.2 2018
Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)
instacron:SBPT
ISSN: 1806-3756
1806-3713
DOI: 10.1590/s1806-37562017000000161
Popis: Objective: To evaluate the impact of smoking on pulmonary tuberculosis (PTB) treatment outcomes and the two-month conversion rates for Mycobacterium tuberculosis sputum cultures among patients with culture-confirmed PTB in an area with a moderate incidence of tuberculosis in Brazil. Methods: This was a retrospective cohort study of PTB patients diagnosed and treated at the Thoracic Diseases Institute of the Federal University of Rio de Janeiro between 2004 and 2012. Results: Of the 298 patients diagnosed with PTB during the study period, 174 were included in the outcome analysis: 97 (55.7%) were never-smokers, 31 (17.8%) were former smokers, and 46 (26.5%) were current smokers. Smoking was associated with a delay in sputum culture conversion at the end of the second month of TB treatment (relative risk = 3.58 &091;95% CI: 1.3-9.86&093;; p = 0.01), as well as with poor treatment outcomes (relative risk = 6.29 &091;95% CI: 1.57-25.21&093;; p = 0.009). The association between smoking and a positive culture in the second month of treatment was statistically significant among the current smokers (p = 0.027). Conclusions: In our sample, the probability of a delay in sputum culture conversion was higher in current smokers than in never-smokers, as was the probability of a poor treatment outcome. RESUMO Objetivo: Avaliar o impacto do tabagismo no desfecho do tratamento da tuberculose pulmonar (TBP) e na taxa de conversão da cultura de Mycobacterium tuberculosis no escarro ao final do segundo mês de tratamento em pacientes com TBP confirmada por cultura em um local com incidência de tuberculose moderada no Brasil. Métodos: Estudo de coorte retrospectivo envolvendo pacientes com TBP diagnosticados e tratados no Instituto de Doenças do Tórax da Universidade Federal do Rio de Janeiro entre 2004 e 2012. Resultados: De 298 pacientes com diagnóstico confirmado de TBP no período do estudo, 174 foram incluídos na análise dos desfechos: 97 nunca fumaram (55,7%), 31 eram ex-tabagistas (17,8%), e 46 eram tabagistas atuais (26,5%). O tabagismo foi associado ao atraso na conversão da cultura do final do segundo mês do tratamento (risco relativo = 3,58 &091;IC95%: 1,30-9,86&093;; p = 0,01), assim como ao desfecho de tratamento não favorável (risco relativo = 6,29 &091;IC95%: 1,57-25,21&093;; p = 0,009). A associação entre tabagismo e cultura positiva ao final do segundo mês de tratamento foi estatisticamente significante entre os tabagistas atuais (p = 0.027). Conclusões: Nesta amostra, os pacientes tabagistas atuais apresentaram uma maior probabilidade de atraso na conversão da cultura após dois meses de tratamento e de desfecho de tratamento não favorável do que aqueles que nunca fumaram.
Databáze: OpenAIRE
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