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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...

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Autores principales: Oliveira, Olena, Gaio, Rita, Correia-Neves, Margarida, Rito, Teresa, Duarte, Raquel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
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.
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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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