ABSTRACT
BACKGROUND: Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcomes. Predictors of poor outcomes vary in different regions. Vietnam is among the top 30 high burden of MDR-TB countries. We describe demographic characteristics and identify risk factors for poor outcome among patients with MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam. METHODS: This retrospective study included 2266 patients who initiated MDR-TB treatment between 2011 and 2015 in HCMC. Treatment outcomes were available for 2240 patients. Data was collected from standardized paper-based treatment cards and electronic records. A Kruskal Wallis test was used to assess changes in median age and body mass index (BMI) over time, and a Wilcoxon test was used to compare the median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression with multiple imputation for missing data was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program. RESULTS: Among 2266 eligible cases, 60.2% had failed on a category I or II treatment regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. The notification rate increased 24.7% from 2011 to 2015. The treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty or 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1 kg/m2 of BMI for patients with BMI < 21). CONCLUSION: The number of patients diagnosed with MDR-TB in HCMC increased by almost a quarter between 2011 and 2015. Patients with HIV, high smear grade, malnutrition or a history of previous MDR-TB treatment are at greatest risk of poor treatment outcome.
Subject(s)
AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/epidemiology , Mycobacterium tuberculosis/genetics , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/epidemiology , Adult , Age Factors , Coinfection , Drug Resistance, Multiple, Bacterial/drug effects , Female , Follow-Up Studies , Humans , Incidence , Male , Microbial Sensitivity Tests , Middle Aged , Mycobacterium tuberculosis/isolation & purification , Retrospective Studies , Risk Factors , Sputum/microbiology , Treatment Outcome , Vietnam/epidemiologyABSTRACT
In this study, we successfully synthesized monodisperse magnetite nanoparticles (NPs) (Fe3O4) by sonochemical method using mono (ethylene glycol) (MEG) as a modifier of the reaction environment and found that MEG could be a good candidate to prevent oxidation and toxicity in sonochemical synthesis. The microstructure and size distribution of the Fe3O4 NPs were characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM) respectively. It revealed that the NPs prepared by MEG assisted sonochemical method show a smaller average size and better monodispersity compared to conventional sonochemical method. Due the the reduced average size and uniform size distribution nature of the NPs, it also showed good superparamagnetic properties with very low coercivity less than 0.5 Oe.
