RESUMO
We investigated whether ancestry-specific genetic factors affect tuberculosis (TB) progression risk in a cohort of admixed Peruvians. We genotyped 2,105 patients with TB and 1,320 household contacts (HHCs) who were infected with Mycobacterium tuberculosis (M. tb) but did not develop TB and inferred each individual's proportion of native Peruvian genetic ancestry. Our HHC study design and our data on potential confounders allowed us to demonstrate increased risk independent of socioeconomic factors. A 10% increase in individual-level native Peruvian genetic ancestry proportion corresponded to a 25% increased TB progression risk. This corresponds to a 3-fold increased risk for individuals in the highest decile of native Peruvian genetic ancestry versus the lowest decile, making native Peruvian genetic ancestry comparable in effect to clinical factors such as diabetes. Our results suggest that genetic ancestry is a major contributor to TB progression risk and highlight the value of including diverse populations in host genetic studies.
RESUMO
RESUMEN Objetivo: Describir las características de la implementación del tratamiento supervisado por video (VDOT) en pacientes con tuberculosis en un establecimiento de salud de la seguridad social del primer nivel de atención en Perú (EsSalud). Material y métodos: Estudio observacional, descriptivo. Los pacientes fueron enrolados de forma prospectiva de 18/09/2018 al 24/09/2019. Ocho de los nueve pacientes seguidos completaron el tratamiento VDOT. Un paciente fue transferido a otro establecimiento de salud antes de terminar el seguimiento. Una enfermera entrenada de Socios En Salud gestionó las 727 video llamadas. Resultados: Se obtuvo una adherencia al tratamiento del 100%. Conclusiones: La estrategia VDOT sería una modalidad alternativa útil en pacientes con tuberculosis sensible.
SUMMARY Objective: To report the characteristics of the implementation process of the video supervised treatment (VST) of patients with pulmonary tuberculosis in a first level health care center of the Social Security in Peru. Methods: An observational study was carried-out including patients enrolled from 18/09/2018 to 24/09/2019. Eight out of ninepatients completed the VST, one patient was transferred to other institution before finishing treatment. One nurse trained at Partners in Health arranged the 727 video calls. Results: adherence to treatment was 100%. Conclusions: VST may be a useful alternative for patients with drug sensitive tuberculosis.