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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057584/ https://www.ncbi.nlm.nih.gov/pubmed/33878119 http://dx.doi.org/10.1371/journal.pone.0250028 |
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author | Oliveira, Olena Gaio, Rita Correia-Neves, Margarida Rito, Teresa Duarte, Raquel |
author_facet | Oliveira, Olena Gaio, Rita Correia-Neves, Margarida Rito, Teresa Duarte, Raquel |
author_sort | Oliveira, Olena |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8057584 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-80575842021-05-04 Evaluation of drug-resistant tuberculosis treatment outcome in Portugal, 2000–2016 Oliveira, Olena Gaio, Rita Correia-Neves, Margarida Rito, Teresa Duarte, Raquel PLoS One Research Article 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. Public Library of Science 2021-04-20 /pmc/articles/PMC8057584/ /pubmed/33878119 http://dx.doi.org/10.1371/journal.pone.0250028 Text en © 2021 Oliveira et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Oliveira, Olena Gaio, Rita Correia-Neves, Margarida Rito, Teresa Duarte, Raquel Evaluation of drug-resistant tuberculosis treatment outcome in Portugal, 2000–2016 |
title | Evaluation of drug-resistant tuberculosis treatment outcome in Portugal, 2000–2016 |
title_full | Evaluation of drug-resistant tuberculosis treatment outcome in Portugal, 2000–2016 |
title_fullStr | Evaluation of drug-resistant tuberculosis treatment outcome in Portugal, 2000–2016 |
title_full_unstemmed | Evaluation of drug-resistant tuberculosis treatment outcome in Portugal, 2000–2016 |
title_short | Evaluation of drug-resistant tuberculosis treatment outcome in Portugal, 2000–2016 |
title_sort | evaluation of drug-resistant tuberculosis treatment outcome in portugal, 2000–2016 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057584/ https://www.ncbi.nlm.nih.gov/pubmed/33878119 http://dx.doi.org/10.1371/journal.pone.0250028 |
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