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Factores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en Paraguay

OBJECTIVE. To determine the factors associated with the unsuccessful treatment of patients diagnosed with drug-sensitive tuberculosis (TB) in Paraguay. METHODS. Retrospective cohort study, with data collected from the national program between January 2016 and March 2017. Unsuccessful treatment was d...

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Autores principales: Montiel, Ivonne, Alarcón, Edith, Aguirre, Sarita, Sequera, Guillermo, Marín, Diana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Organización Panamericana de la Salud 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428186/
https://www.ncbi.nlm.nih.gov/pubmed/32818034
http://dx.doi.org/10.26633/RPSP.2020.89
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author Montiel, Ivonne
Alarcón, Edith
Aguirre, Sarita
Sequera, Guillermo
Marín, Diana
author_facet Montiel, Ivonne
Alarcón, Edith
Aguirre, Sarita
Sequera, Guillermo
Marín, Diana
author_sort Montiel, Ivonne
collection PubMed
description OBJECTIVE. To determine the factors associated with the unsuccessful treatment of patients diagnosed with drug-sensitive tuberculosis (TB) in Paraguay. METHODS. Retrospective cohort study, with data collected from the national program between January 2016 and March 2017. Unsuccessful treatment was defined as patients who were lost to follow-up, failed treatment, or died. Factors associated with unsuccessful treatment were determined using Poisson regression; the adjusted relative risk (RR) and 95% confidence interval (95% CI) were estimated by health region. RESULTS. A total of 3 034 cases were studied: 2 189 (72.1%) were successfully treated (cured: 1 221 [40.2%], complete treatment: 968 [31.9%]) and 845 (27.9%) were unsuccessfully treated (treatment failure: 40 [1.3%], loss to follow-up: 466 [15.4%] and deaths: 339 [11.2%]). Factors associated with unsuccessful treatment were masculine sex 1.28 (1.14- 1.42), indigenous descent 1.3 (1.09- 1.54), lack of report of area of residence 1.27 (1.02- 1.57), TB/HIV coinfection 1.97 (1, 63- 2.38), illicit drug addiction 1.38 (1.16- 1.63), alcohol consumption 1.25 (1.02- 1.52), previous treatment 1.23 (1.10- 1.38) and lack of treatment monitoring data 4.92 (3.69- 6.56). Being deprived of liberty 0.65 (0.47- 0.89) and TB/diabetes comorbidity 0.80 (0.67- 0.95) were considered protective factors. CONCLUSION. Paraguay has a high percentage of unsuccessful treatment in almost the entire country, without reaching the target proposed by the World Health Organization. Associated risk factors such as HIV, consumption of legal and illicit drugs, and being indigenous highlight the need to revise the treatment strategies with an inter-institutional approach.
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spelling pubmed-74281862020-08-17 Factores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en Paraguay Montiel, Ivonne Alarcón, Edith Aguirre, Sarita Sequera, Guillermo Marín, Diana Rev Panam Salud Publica Investigación Original OBJECTIVE. To determine the factors associated with the unsuccessful treatment of patients diagnosed with drug-sensitive tuberculosis (TB) in Paraguay. METHODS. Retrospective cohort study, with data collected from the national program between January 2016 and March 2017. Unsuccessful treatment was defined as patients who were lost to follow-up, failed treatment, or died. Factors associated with unsuccessful treatment were determined using Poisson regression; the adjusted relative risk (RR) and 95% confidence interval (95% CI) were estimated by health region. RESULTS. A total of 3 034 cases were studied: 2 189 (72.1%) were successfully treated (cured: 1 221 [40.2%], complete treatment: 968 [31.9%]) and 845 (27.9%) were unsuccessfully treated (treatment failure: 40 [1.3%], loss to follow-up: 466 [15.4%] and deaths: 339 [11.2%]). Factors associated with unsuccessful treatment were masculine sex 1.28 (1.14- 1.42), indigenous descent 1.3 (1.09- 1.54), lack of report of area of residence 1.27 (1.02- 1.57), TB/HIV coinfection 1.97 (1, 63- 2.38), illicit drug addiction 1.38 (1.16- 1.63), alcohol consumption 1.25 (1.02- 1.52), previous treatment 1.23 (1.10- 1.38) and lack of treatment monitoring data 4.92 (3.69- 6.56). Being deprived of liberty 0.65 (0.47- 0.89) and TB/diabetes comorbidity 0.80 (0.67- 0.95) were considered protective factors. CONCLUSION. Paraguay has a high percentage of unsuccessful treatment in almost the entire country, without reaching the target proposed by the World Health Organization. Associated risk factors such as HIV, consumption of legal and illicit drugs, and being indigenous highlight the need to revise the treatment strategies with an inter-institutional approach. Organización Panamericana de la Salud 2020-08-14 /pmc/articles/PMC7428186/ /pubmed/32818034 http://dx.doi.org/10.26633/RPSP.2020.89 Text en https://creativecommons.org/licenses/by-nc-nd/3.0/igo/legalcode Este es un artículo de acceso abierto distribuido bajo los términos de la licencia Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO, que permite su uso, distribución y reproducción en cualquier medio, siempre que el trabajo original se cite de la manera adecuada. No se permiten modificaciones a los artículos ni su uso comercial. Al reproducir un artículo no debe haber ningún indicio de que la OPS o el artículo avalan a una organización o un producto específico. El uso del logo de la OPS no está permitido. Esta leyenda debe conservarse, junto con la URL original del artículo.
spellingShingle Investigación Original
Montiel, Ivonne
Alarcón, Edith
Aguirre, Sarita
Sequera, Guillermo
Marín, Diana
Factores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en Paraguay
title Factores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en Paraguay
title_full Factores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en Paraguay
title_fullStr Factores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en Paraguay
title_full_unstemmed Factores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en Paraguay
title_short Factores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en Paraguay
title_sort factores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en paraguay
topic Investigación Original
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428186/
https://www.ncbi.nlm.nih.gov/pubmed/32818034
http://dx.doi.org/10.26633/RPSP.2020.89
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