Brazilian cohort study of risk factors associated with unsuccessful outcomes of drug resistant tuberculosis

Bartholomay, Patrícia; Pinheiro, Rejane Sobrino; Dockhorn, Fernanda; Pelissari, Daniele Maria; Araújo, Wildo Navegantes de

doi:10.1186/s12879-021-06756-7

Cited by 6 publications

(7 citation statements)

References 31 publications

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“…Thus, the site did not achieve the WHO recommended target of ≥75% for treatment success [18]. The treatment success rate (63.9%) observed in the current cohort was in line with the success rates reported by a meta-analysis (63.8%) [20], a study conducted in Sudan (63.5%) [21], and in China (63.4%) [22]. However, it was comparatively better than the treatment success rates reported in studies conducted in Morocco (53.5%) [23], Armenia (56.5%) [24], Ukraine (18.1%) [25], and India (38%) [26].…”

Section: Discussionsupporting

confidence: 85%

Assessment of Factors Associated with Unfavorable Outcomes among Drug-Resistant TB Patients: A 6-Year Retrospective Study from Pakistan

Khan

Khan²,

Hayat

et al. 2022

IJERPH

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The spread of drug-resistant tuberculosis (DR TB) poses significant challenges to the control and successful eradication of TB globally. The current retrospective study was designed to evaluate the treatment outcomes and identify the risk factors associated with unsuccessful outcomes among DR TB patients. A total of 277/308 eligible DR TB patients were enrolled for treatment at the programmatic management unit of DR TB at the Pakistan Institute of Medical Sciences, Islamabad between January 2014 and July 2019. Treatment outcomes were defined according to the WHO recommendations. Death, treatment failure, and lost to follow-up (LTFU) were collectively grouped as unsuccessful treatment outcomes, whereas cured and treatment completed were summed up together as successful treatment outcomes. Out of the total 277 patients, 265 (95.67%) were multidrug/rifampicin-resistant TB (MDR/RR-TB) cases, 8 (2.89%) were isoniazid resistant cases, and 4 (1.44%) were extensively drug-resistant ones. In the current cohort, a total of 177 (63.9%) achieved successful treatment outcomes. Among them, 153 (55.2%) were declared cured and 24 (8.7%) completed their treatment. Of the remaining 100 (36.1%) patients with unsuccessful outcomes, 60 (21.7%) died, 32 (11.5%) were LTFU, and 8 (2.9%) had failed treatment. The proportion of male patients was relatively higher (55.2%), within the age group of 21–40 years (47.3%) and lived in rural areas (66.8%). The multivariate analysis revealed that unsuccessful outcomes had a statistically significant association with being male (adjusted odds ratio, AOR: 1.92, 95% confidence interval (CI): 1.10–3.36), being in an age group above 60 years (AOR: 3.34, 95% CI: 1.09–10.1), suffering from any comorbidity (AOR: 2.69, 95% CI: 1.35–5.38), and the history of use of second-line drugs (AOR; 3.51, 95% CI 1.35–9.12). In conclusion, treatment outcomes among DR TB patients at the study site were poor and did not achieve the treatment success target (≥75%) set by the World Health Organization.

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Section: Discussionsupporting

confidence: 85%

Assessment of Factors Associated with Unfavorable Outcomes among Drug-Resistant TB Patients: A 6-Year Retrospective Study from Pakistan

Khan

Khan²,

Hayat

et al. 2022

IJERPH

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“…The important characteristics and outcomes of the included articles were collated ( Table 1 ). Eight articles were conducted in China ( 3 ), one each in Columbia ( 4 ), Russia ( 18 ), India ( 19 ), Mexico ( 20 ), Croatia ( 7 ), South Africa ( 10 ), and Brazil ( 21 ). The majority of the publications were prospective studies.…”

Section: Resultsmentioning

confidence: 99%

Effect of alcohol consumption on relapse outcomes among tuberculosis patients: A systematic review and meta-analysis

Weiangkham

Umnuaypornlert²,

Saokaew³

et al. 2022

Front. Public Health

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IntroductionTuberculosis (TB) is one of the major public health issues in every country. Alcohol consumption is one of the reasons associated with the severity of symptoms and death among TB patients. The impact of alcohol use on TB relapse outcomes is still debatable. This study aimed to conduct a systematic review and meta-analysis (SR/MA) to find the link between alcohol use and TB relapse outcomes.MethodsData collection was performed from December 2021 to March 2022; and was obtained from electronic databases including CINAHL, PubMed, and Scopus. The researcher carefully searched and reviewed all the relevant research concerning drinking alcohol and relapse outcomes among TB patients. A set of inclusion and exclusion criteria was used to assess research publications. The methodological quality of eligible publications was assessed using the Newcastle–Ottawa Scale. Random meta-analysis was used to determine odds ratios (ORs) with a 95% confidence interval (CIs). The funnel plot, Begg's test, and Egger's test were employed to investigate publication bias.ResultsThere were a total of 2,113 studies found and reviewed, and eight publications were chosen for the analysis. It was found that among TB patients with a moderate appearance of heterogeneity, drinking alcohol increases the probability of relapse (OR = 3.64; 95% CI: 2.26–5.88, p < 0.001) and mortality (OR = 1.72; 95% CI: 1.40–2.12, p < 0.001). The funnel plot, Begg's test, and Egger's test all revealed that there was no indication of publication bias.ConclusionsRelapses and mortality among tuberculosis patients are considerably increased by alcohol drinking. More research into the causality of this link between the degree of alcohol use and the underlying processes is required.Systematic review registrationPROSPERO [CRD 42022295865].

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“…MDR-TB patients in Bahia are predominantly males belonging to black ethnicity and have low education levels. Non-white ethnicity and low education level were previously associated with poorer MDR-TB treatment outcome in Brazil 23 . Male sex and low education levels are associated with TB treatment default 24 and MDR-TB 25 .…”

Section: Discussionmentioning

confidence: 93%

“…TB-HIV coinfection is associated with progressively more resistant forms of TB 31 , as well as increased risk of adverse events and death, especially for patients not undergoing antiretroviral treatment 32 . HIV coinfection was associated with death among MDR-TB patients in Brazil 23 . All HIV-positive MDR-TB patients in our setting died.…”

Section: Discussionmentioning

confidence: 97%

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Laboratory-based study of drug resistance and genotypic profile of multidrug-resistant tuberculosis isolates in Salvador, Bahia, Brazil

Sousa

Carneiro

Montes

et al. 2022

Rev. Soc. Bras. Med. Trop.

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Background: Surveillance of multidrug resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) is essential to guide disease dissemination control measures. Brazil contributes to a significant fraction of tuberculosis (TB) cases worldwide, but only few reports addressed MDR/XDR-TB in the country.Methods: This cross-sectional, laboratory-based study describes the phenotypic resistance profiles of isolates obtained between January 2008 and December 2011 in Bahia, Brazil, and sociodemographic, epidemiological, and clinical characteristics (obtained from mandatory national registries) of the corresponding 204 MDR/XDR-TB patients. We analyzed the mycobacterial spoligotyping and variable number of tandem repeats of mycobacterial interspersed repetitive units in 12-loci profiles obtained from Salvador.Results: MDR/XDR-TB patients were predominantly male, had a median age of 43 years, belonged to black ethnicity, and failed treatment before MDR-TB diagnosis. Nearly one-third of the isolates had phenotypic resistance (evaluated by mycobacteria growth indicator tube assay) to second-line anti-TB drugs (64/204, 31%), of which 22% cases (14/64) were diagnosed as XDR-TB. Death was a frequent outcome among these individuals and was associated with resistance to second-line anti-TB drugs. Most isolates successfully genotyped belonged to the Latin-American Mediterranean (LAM) Family, with an unprecedented high proportion of LAM10-Cameroon subfamily bacilli. More than half of these isolates were assigned to a unique cluster by the genotyping methods performed. Large clusters of identical genotypes were also observed among LAM SIT42 and SIT376 strains. Conclusions:We highlight the need for strengthening local and national efforts to perform early detection of TB drug resistance and to prevent treatment discontinuation to limit the emergence of drug-resistant strains.

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Brazilian cohort study of risk factors associated with unsuccessful outcomes of drug resistant tuberculosis

Cited by 6 publications

References 31 publications

Assessment of Factors Associated with Unfavorable Outcomes among Drug-Resistant TB Patients: A 6-Year Retrospective Study from Pakistan

Assessment of Factors Associated with Unfavorable Outcomes among Drug-Resistant TB Patients: A 6-Year Retrospective Study from Pakistan

Effect of alcohol consumption on relapse outcomes among tuberculosis patients: A systematic review and meta-analysis

Laboratory-based study of drug resistance and genotypic profile of multidrug-resistant tuberculosis isolates in Salvador, Bahia, Brazil

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