Estimated rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a four-drug fixed-dose combination regimen at a tertiary health care facility in the city of Rio de Janeiro, Brazil

Abstract

Objective: To estimate the rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a four-drug fixed-dose combination (FDC) regimen, as well as to evaluate possible associated factors. Methods: This was a retrospective observational study involving 208 patients with a confirmed diagnosis of pulmonary tuberculosis enrolled in the Hospital Tuberculosis Control Program at the Institute for Thoracic Diseases, located in the city of Rio de Janeiro, Brazil. Between January of 2007 and October of 2010, the patients were treated with the rifampinisoniazid-pyrazinamide (RHZ) regimen, whereas, between November of 2010 and June of 2013, the patients were treated with the rifampin-isoniazid-pyrazinamide-ethambutol FDC (RHZE/FDC) regimen. Data regarding tuberculosis recurrence and mortality in the patients studied were retrieved from the Brazilian Case Registry Database and the Brazilian Mortality Database, respectively. The follow-up period comprised two years after treatment completion. Results: The rates of cure, treatment abandonment, and death were 90.4%, 4.8%, and 4.8%, respectively. There were 7 cases of recurrence during the follow-up period. No significant differences in the recurrence rate were found between the RHZ and RHZE/FDC regimen groups (p = 0.13). We identified no factors associated with the occurrence of recurrence; nor were there any statistically significant differences between the treatment groups regarding adverse effects or rates of cure, treatment abandonment, or death. Conclusions: The adoption of the RHZE/ FDC regimen produced no statistically significant differences in the rates of recurrence, cure, or treatment abandonment; nor did it have any effect on the occurrence of adverse effects, in comparison with the use of the RHZ regimen.

Relapse or Re-Infection, the Situation of Recurrent Tuberculosis in Eastern China

“…Therefore, the rate of reported relapse or re-infection varied widely in different studies. The relationship between the risk factors, such as age, gender, and cavitation on chest X-ray, and recurrence were controversial in past studies (Moosazadeh et al, 2015;Silva et al, 2017;Cudahy et al, 2020), in our study there was no significant association between those factors and different recurrence types.…”

The four-drug fixed-dose combination reduced the loss to follow up from TB treatment in Brazil: additional evidence comparing two prospective cohorts at the same health centers

“…Accordingly, the present study showed a reduction in the accumulated incidence of LTFU in the second treatment period (4-FDC) of around 40%. Conversely, two Brazilian studies from secondary data did not nd signi cant differences in the rates of recurrence, cure, and LTFU between the RH-FDC + Z and RHZE-FDC groups [20,21].…”

Fatores Associados Ao Abandono Do Tratamento Da Tuberculose Pulmonar

“…Neste estudo, a minoria dos casos (8,56%) abandonou o tratamento de tuberculose pulmonar. Semelhante aos estudos realizados no Hospital do Rio de Janeiro-RJ entre 2007 a 2013 (4,8%) (10) ; no Estado de Alagoas entre 2008 a 2017 (12,27%) (11) ; e em Pernambuco (11,3%) entre 2011 a 2014 (12) . O abandono do tratamento geralmente está relacionado com mau prognóstico (13) .…”