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Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study.
Van, Le Hong; Phu, Phan Trieu; Vinh, Dao Nguyen; Son, Vo Thanh; Hanh, Nguyen Thi; Nhat, Le Thanh Hoang; Lan, Nguyen Huu; Vinh, Truong Van; Trang, Nguyen Thi Mai; Ha, Dang Thi Minh; Thwaites, Guy E; Thuong, Nguyen Thuy Thuong.
Afiliación
  • Van LH; Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam. vanlh@oucru.org.
  • Phu PT; Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam.
  • Vinh DN; Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam.
  • Son VT; Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam.
  • Hanh NT; Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam.
  • Nhat LTH; Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam.
  • Lan NH; Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam.
  • Vinh TV; Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam.
  • Trang NTM; Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam.
  • Ha DTM; Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam.
  • Thwaites GE; Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam.
  • Thuong NTT; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
BMC Infect Dis ; 20(1): 164, 2020 Feb 22.
Article en En | MEDLINE | ID: mdl-32087682
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Oportunistas Relacionadas con el SIDA / Tuberculosis Resistente a Múltiples Medicamentos / Mycobacterium tuberculosis Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2020 Tipo del documento: Article País de afiliación: Vietnam Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Oportunistas Relacionadas con el SIDA / Tuberculosis Resistente a Múltiples Medicamentos / Mycobacterium tuberculosis Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2020 Tipo del documento: Article País de afiliación: Vietnam Pais de publicación: Reino Unido