Evaluation of drug-resistant tuberculosis treatment outcome in Portugal, 2000–2016

Treatment of drug-resistant tuberculosis (TB), which is usually less successful than that of drug-susceptible TB, represents a challenge for TB control and elimination. We aimed to evaluate treatment outcomes and to identify the factors associated with death among patients with MDR and XDR-TB in Por...

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Vydáno v:PloS one Ročník 16; číslo 4; s. e0250028
Hlavní autoři: Oliveira, Olena, Gaio, Rita, Correia-Neves, Margarida, Rito, Teresa, Duarte, Raquel
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Public Library of Science 20.04.2021
Public Library of Science (PLoS)
Témata:
Antiretroviral drugs
Biology and Life Sciences
Care and treatment
Chronic obstructive pulmonary disease
Clinical outcomes
Diabetes mellitus
Drug abuse
Drug resistance
Editing
Epidemiology
Extensively drug-resistant tuberculosis
Fatalities
Fluoroquinolones
Gender
Health sciences
Health services
HIV
Homeless people
Homelessness
Human immunodeficiency virus
Isoniazid
Laboratories
Liver diseases
Living conditions
Lung diseases
Mathematical analysis
Medical diagnosis
Medical treatment
Medicine
Medicine and Health Sciences
Multidrug resistance
Obstructive lung disease
Patient outcomes
Patients
People and places
Physiological aspects
Public health
Radiography
Rifampin
Sexually transmitted diseases
Silicosis
Statistical analysis
STD
Success
Surveillance
Tuberculosis
Portugal
ISSN:1932-6203, 1932-6203
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Shrnutí:Treatment of drug-resistant tuberculosis (TB), which is usually less successful than that of drug-susceptible TB, represents a challenge for TB control and elimination. We aimed to evaluate treatment outcomes and to identify the factors associated with death among patients with MDR and XDR-TB in Portugal. We assessed MDR-TB cases reported for the period 2000–2016, using the national TB Surveillance System. Treatment outcomes were defined according to WHO recommendations. We identified the factors associated with death using logistic regression. We evaluated treatment outcomes of 294 MDR- and 142 XDR-TB patients. The treatment success rate was 73.8% among MDR- and 62.7% among XDR-TB patients (p = 0.023). The case-fatality rate was 18.4% among MDR- and 23.9% among XDR-TB patients. HIV infection (OR 4.55; 95% CI 2.31–8.99; p < 0.001) and resistance to one or more second-line injectable drugs (OR 2.73; 95% CI 1.26–5.92; p = 0.011) were independently associated with death among MDR-TB patients. HIV infection, injectable drug use, past imprisonment, comorbidities, and alcohol abuse are conditions that were associated with death early on and during treatment. Early diagnosis of MDR-TB and further monitoring of these patients are necessary to improve treatment outcome.
Bibliografie:ObjectType-Article-1
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0250028