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Predictors of treatment outcomes among patients with multidrug-resistant tuberculosis in Vietnam: a retrospective cohort study

BACKGROUND: Improving treatment outcomes for multidrug-resistant tuberculosis (MDR-TB) is a leading priority for global TB control. This retrospective cohort study evaluated the factors associated with treatment success among patients treated for MDR-TB in two provinces in Vietnam. METHODS: Treatmen...

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Autores principales: Wrohan, Ian, Nguyen, Thu Anh, Nguyen, Viet Nhung, Nguyen, Binh Hoa, Hoang, Thi Thanh Thuy, Nguyen, Phuong Chi, Velen, Kavindhran, Marks, Guy Barrington, Fox, Greg James
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8772201/
https://www.ncbi.nlm.nih.gov/pubmed/35057754
http://dx.doi.org/10.1186/s12879-021-06992-x
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author Wrohan, Ian
Nguyen, Thu Anh
Nguyen, Viet Nhung
Nguyen, Binh Hoa
Hoang, Thi Thanh Thuy
Nguyen, Phuong Chi
Velen, Kavindhran
Marks, Guy Barrington
Fox, Greg James
author_facet Wrohan, Ian
Nguyen, Thu Anh
Nguyen, Viet Nhung
Nguyen, Binh Hoa
Hoang, Thi Thanh Thuy
Nguyen, Phuong Chi
Velen, Kavindhran
Marks, Guy Barrington
Fox, Greg James
author_sort Wrohan, Ian
collection PubMed
description BACKGROUND: Improving treatment outcomes for multidrug-resistant tuberculosis (MDR-TB) is a leading priority for global TB control. This retrospective cohort study evaluated the factors associated with treatment success among patients treated for MDR-TB in two provinces in Vietnam. METHODS: Treatment outcomes were evaluated for adult patients treated in Hanoi and Thanh Hoa provinces between 2014 and 2016. The primary outcome was the proportion of patients with treatment success, defined as cure or treatment completion. Logistic regression analysis was used to evaluate the relationship between patient clinical and microbiological characteristics and treatment success. RESULTS: Treatment outcomes were reported in 612 of 662 patients; of these, 401 (65.5)% were successfully treated. The odds of treatment success were lower for male patients (aOR 0.56, 95% CI 0.34–0.90), for people living with HIV (aOR 0.44, 95% CI 0.20–1.00), and for patients treated for extensive antibiotic resistance (pre-XDR-/XDT-TB) (aOR 0.53, 95% CI 0.29–0.97), compared with others. Patients who achieved culture conversion in the first 4 months of treatment had increased odds (aOR 2.93, 95% CI 1.33–6.45) of treatment success. In addition, loss to follow-up was less common among patients covered by social health insurance compared to those who paid for treatment out-of-pocket (aOR 0.55, 95% CI 0.32–0.95). CONCLUSIONS: Among patients with MDR-TB, males, people living with HIV, and those with more extensive antibiotic resistance at diagnosis are at greatest risk of an unsuccessful treatment outcome. Efforts to optimise the management of co-morbidities (such as HIV), ensure rapid bacteriological conversion, and provide financial support for patients promise to improve treatment outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06992-x.
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spelling pubmed-87722012022-01-20 Predictors of treatment outcomes among patients with multidrug-resistant tuberculosis in Vietnam: a retrospective cohort study Wrohan, Ian Nguyen, Thu Anh Nguyen, Viet Nhung Nguyen, Binh Hoa Hoang, Thi Thanh Thuy Nguyen, Phuong Chi Velen, Kavindhran Marks, Guy Barrington Fox, Greg James BMC Infect Dis Research BACKGROUND: Improving treatment outcomes for multidrug-resistant tuberculosis (MDR-TB) is a leading priority for global TB control. This retrospective cohort study evaluated the factors associated with treatment success among patients treated for MDR-TB in two provinces in Vietnam. METHODS: Treatment outcomes were evaluated for adult patients treated in Hanoi and Thanh Hoa provinces between 2014 and 2016. The primary outcome was the proportion of patients with treatment success, defined as cure or treatment completion. Logistic regression analysis was used to evaluate the relationship between patient clinical and microbiological characteristics and treatment success. RESULTS: Treatment outcomes were reported in 612 of 662 patients; of these, 401 (65.5)% were successfully treated. The odds of treatment success were lower for male patients (aOR 0.56, 95% CI 0.34–0.90), for people living with HIV (aOR 0.44, 95% CI 0.20–1.00), and for patients treated for extensive antibiotic resistance (pre-XDR-/XDT-TB) (aOR 0.53, 95% CI 0.29–0.97), compared with others. Patients who achieved culture conversion in the first 4 months of treatment had increased odds (aOR 2.93, 95% CI 1.33–6.45) of treatment success. In addition, loss to follow-up was less common among patients covered by social health insurance compared to those who paid for treatment out-of-pocket (aOR 0.55, 95% CI 0.32–0.95). CONCLUSIONS: Among patients with MDR-TB, males, people living with HIV, and those with more extensive antibiotic resistance at diagnosis are at greatest risk of an unsuccessful treatment outcome. Efforts to optimise the management of co-morbidities (such as HIV), ensure rapid bacteriological conversion, and provide financial support for patients promise to improve treatment outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06992-x. BioMed Central 2022-01-20 /pmc/articles/PMC8772201/ /pubmed/35057754 http://dx.doi.org/10.1186/s12879-021-06992-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Wrohan, Ian
Nguyen, Thu Anh
Nguyen, Viet Nhung
Nguyen, Binh Hoa
Hoang, Thi Thanh Thuy
Nguyen, Phuong Chi
Velen, Kavindhran
Marks, Guy Barrington
Fox, Greg James
Predictors of treatment outcomes among patients with multidrug-resistant tuberculosis in Vietnam: a retrospective cohort study
title Predictors of treatment outcomes among patients with multidrug-resistant tuberculosis in Vietnam: a retrospective cohort study
title_full Predictors of treatment outcomes among patients with multidrug-resistant tuberculosis in Vietnam: a retrospective cohort study
title_fullStr Predictors of treatment outcomes among patients with multidrug-resistant tuberculosis in Vietnam: a retrospective cohort study
title_full_unstemmed Predictors of treatment outcomes among patients with multidrug-resistant tuberculosis in Vietnam: a retrospective cohort study
title_short Predictors of treatment outcomes among patients with multidrug-resistant tuberculosis in Vietnam: a retrospective cohort study
title_sort predictors of treatment outcomes among patients with multidrug-resistant tuberculosis in vietnam: a retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8772201/
https://www.ncbi.nlm.nih.gov/pubmed/35057754
http://dx.doi.org/10.1186/s12879-021-06992-x
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