Predictive factors for unfavourable treatment in MDR-TB and XDR-TB patients in Rio de Janeiro State, Brazil, 2000-2016
Autoři:
Marcela Bhering aff001; Raquel Duarte aff003; Afrânio Kritski aff001
Působiště autorů:
School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
aff001; Brazilian Tuberculosis Research Network / REDE TB, Rio de Janeiro, Brazil
aff002; EPIUnit, Public Health Institute, University of Porto, Porto, Portugal
aff003; Public Health Science and Medical Education Department, School of Medicine, University of Porto, Porto, Portugal
aff004
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0218299
Souhrn
Setting
The State of Rio de Janeiro stands out as having the second highest incidence and the highest mortality rate due to TB in Brazil. This study aims at identifying the factors associated with the unfavourable treatment of MDR/XDR-TB patients in that State.
Method
Data on 2269 MDR-TB cases reported in 2000–2016 in Rio de Janeiro State were collected from the Tuberculosis Surveillance System. Bivariate and multivariate logistic regressions were run to estimate the factors associated with unfavourable outcomes (failure, default, and death) and, specifically, default and death.
Results
The proportion of unfavourable outcomes was 41.9% among MDR-TB and 81.5% among XDR-TB. Having less than 8 years of schooling, and being an Afro-Brazilian, under 40 years old and drug user were associated with unfavourable outcome and default. Bilateral disease, HIV positive, and comorbidities were associated with death. XDR-TB cases had a 4.7-fold higher odds of an unfavourable outcome, with 29.3% of such cases being not treated for multidrug resistance in the past.
Conclusion
About 30% of XDR-TB cases may have occurred by primary transmission. The high rates of failure and death in this category reflect the limitation of treatment options. This highlights the urgency to incorporate new drugs in the treatment.
Klíčová slova:
Tuberculosis – Drug therapy – Extensively drug-resistant tuberculosis – Brazil – Drug users – Multi-drug-resistant tuberculosis
Zdroje
1. World Health Organization (WHO). Global Tuberculosis Report 2018. Geneva:WHO. 2018.
2. Raviglione MC, Smith IM. XDR Tuberculosis—Implications for Global Public Health. N Engl J Med [Internet]. 2007;356(7):656–9. doi: 10.1056/NEJMp068273 17301295
3. Secretaria de Vigilância em Saúde, Ministério da Saúde. Implantação do Plano Nacional pelo Fim da Tuberculose como Problema de Saúde Pública no Brasil: primeiros passos rumo ao alcance das metas. Bol Epidemiol. 2018;49:18.
4. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa nacional por amostra de domicílios (PNAD) 2015. https://www.ibge.gov.br/estatisticas-novoportal/sociais/rendimento-despesa-e-consumo/9127-pesquisa-nacional-por-amostra-de-domicilios.html?=&t=series-historicas.
5. Wilhelm D, Rodrigues MV, Nakata PT, Godoy SDC, Blatt CR. Descentralização do Acesso ao Sistema de Informações de tratamentos especiais em tuberculose. Rev Baiana Enfermagem. 2018;32:1–10.
6. Brasil. Departamento de Vigilância Epidemiológica, Secretaria de Vigilância em Saúde, Ministério da Saúde. Manual de recomendações para o controle da tuberculose no Brasil. Brasília: Ministério da Saúde, 2018.
7. Bastos ML, Cosme LB, Fregona G, do Prado TN, Bertolde AI, Zandonade E, et al. Treatment outcomes of MDR-tuberculosis patients in Brazil: A retrospective cohort analysis. BMC Infect Dis. 2017;17(1):1–12. doi: 10.1186/s12879-016-2122-x
8. Brasil. Departamento de Vigilância Epidemiológica, Secretaria de Vigilância em Saúde, Ministério da Saúde. Manual de recomendações para o controle da tuberculose no Brasil. Brasília: Ministério da Saúde, 2011.
9. Brasil. Programa Nacional de Controle da Tuberculose, Departamento de Vigilância Epidemiológica, Secretaria de Vigilância em Saúde, Ministério da Saúde. Nota técnica sobre as mudanças no tratamento da tuberculose no Brasil para adultos e adolescentes—versão 2. Brasília: Ministério da Saúde, 2009
10. Global Laboratory Initiative. Global Laboratory initiative guide to TB specimen referral system and integrated networks. Geneva, Switzerland: GLI Working Group Secretariat, 2018. Available from: http://www.stoptb.org/wg/gli/
11. Brasil. Programa Nacional de Controle da Tuberculose, Departamento de Vigilância das Doenças Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde. Nota Informativa n. 8. Novas recomendações para o tratamento da tuberculose multidrogarresistente e com resistência à rifampicina diagnosticada por meio do Teste Rápido Molecular para Tuberculose no Brasil. Brasília: 2016.
12. World Health Organization (WHO). Anti-tuberculosis drug resistance in the world: third global report/ The WHO/IUATLD Global Project on Anti-Tuberculosis Drug Resistance Surveillance, 1999–2002. Geneva:WHO. 2004.
13. Bastos ML, Lan Z, Menzies D. An updated systematic review and meta-analysis for treatment of multidrug-resistant tuberculosis. Eur Respir J. 2017;49(3): pii:1600803. doi: 10.1183/13993003.00803-2016 28331031
14. Karo B, Hauer B, Hollo V, van der Werf MJ, Fiebig L, Haas W. Tuberculosis treatment outcome in the European Union and European Economic Area: an analysis of surveillance data from 2002–2011. Euro Surveill. 2015;20(49):1–10.
15. Dalcolmo MP, Andrade MKDN, Picon PD. Tuberculose multirresistente no Brasil: histórico e medidas de controle. Rev Saude Publica. 2007;41:34–42. doi: 10.1590/s0034-89102007000800006
16. Paula HC de, Aguiar AC de. O abandono do tratamento da tuberculose na estratégia saúde da família: estudo qualitativo em uma área programática do Rio de Janeiro. Rev Baiana Saude Publica.2013;192–204.
17. BRASIL. Lei nº 8.080, de 19 de setembro de 1990. Lei Orgânica da Saúde. Dispõe sobre as condições para a promoção, proteção e recuperação da saúde, a organização e o funcionamento dos serviços correspondentes e dá outras providências. Brasília, set. 1990.
18. Brasil. Conselho Nacional de Secretários de Saúde. Assistência Farmacêutica no SUS / Conselho Nacional de Secretários de Saúde. Brasília : CONASS, 2007.
19. Tanimura T, Jaramillo E, Weil D, Raviglione M, Lönnroth K. Financial burden for tuberculosis patients in low- and middle-income countries: A systematic review. Eur Respir J. 2014;43(6):1763–75. doi: 10.1183/09031936.00193413 24525439
20. Rudgard WE, Chagas NS, Gayoso R, Barreto ML, Boccia D, Smeeth L, et al. Uptake of governmental social protection and financial hardship during drug-resistant tuberculosis treatment in Rio de Janeiro, Brazil. Eur Respir J. 2018;51:1800274. doi: 10.1183/13993003.00274-2018 29567727
21. Andrade KVF de, Nery JS, Souza RA de, Pereira SM. Effects of social protection on tuberculosis treatment outcomes in low or middle-income and in high-burden countries: systematic review and meta-analysis. Cad Saude Publica. 2018;34(1):1–18.
22. Andrews JR, Shah NS, Weissman D, Moll AP, Friedland G, Gandhi NR. Predictors of multidrug-and extensively drug-resistant tuberculosis in a high HIV prevalence community. PLoS One. 2010;5(12):1–6.
23. Samuels JP, Sood A, Campbell JR, Ahmad Khan F, Johnston JC. Comorbidities and treatment outcomes in multidrug resistant tuberculosis: a systematic review and meta-analysis. Sci Rep. 2018;8(1):4980. doi: 10.1038/s41598-018-23344-z 29563561
24. Cherkaoui I, Sabouni R, Ghali I, Kizub D, Billioux AC, Bennani K, et al. Treatment default amongst patients with tuberculosis in urban Morocco: Predicting and explaining default and post-default sputum smear and drug susceptibility results. PLoS One. 2014;9(4):e93574. doi: 10.1371/journal.pone.0093574 24699682
25. Silva DR, Muñoz-torrico M, Duarte R, Galvão T, Bonini EH, Arbex FF. Fatores de risco para tuberculose: diabetes , tabagismo , álcool e uso de outras drogas. J Bras Pneum. 2018;44(2):145–52.
26. Atif M, Bashir A, Ahmad N, Fatima RK, Saba S, Scahill S. Predictors of unsuccessful interim treatment outcomes of multidrug resistant tuberculosis patients. BMC Infect Dis. 2017;17(1):1–12. doi: 10.1186/s12879-016-2122-x
27. Ahmad N, Javaid A, Azhar S, Sulaiman S, Ming LC, Ahmad I, et al. Resistance patterns, prevalence, and predictors of fluoroquinolones resistance in multidrug resistant tuberculosis patients. Braz J Infect Dis.2016 Jan-Feb;20(1):41–7. doi: 10.1016/j.bjid.2015.09.011 26626164
28. Falcão JM, Pisco AM, Simões JA, Falcão IM, Pimenta ZP, Nunes B. Prescrição de antibacterianos em Clínica Geral: Um estudo na Rede Médicos-Sentinela. Rev Port Clin Geral. 2003;19:315–29.
29. Falzon D, Gandhi N, Migliori GB, Sotgiu G, Cox HS, Holtz TH, et al. Resistance to fluoroquinolones and second-line injectable drugs: Impact on multidrug-resistant TB outcomes. Eur Respir J. 2013;42(1):156–68. doi: 10.1183/09031936.00134712 23100499
30. Gandhi NR, Nunn P, Dheda K, Schaaf HS, Zignol M, van Soolingen D, et al. Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis. Lancet Respir Med. 2010;375(9728):1830–43.
31. Qazi F, Khan U, Khowaja S, et al. Predictors of delayed culture conversion in patients treated for multidrug-resistant tuberculosis in Pakistan. Int J Tuberc Lung Dis. 2011;15(11):1556–9. doi: 10.5588/ijtld.10.0679 22008773
32. Kurbatova EV, Cegielski JP, Lienhardt C, et al. Sputum culture conversion as a prognostic marker for end-of-treatment outcome in patients with multidrug-resistant tuberculosis: a secondary analysis of data from two observational cohort studies. Lancet Respir Med. 2015;3(3):201–9. doi: 10.1016/S2213-2600(15)00036-3 25726085
Článok vyšiel v časopise
PLOS One
2019 Číslo 11
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
- Nejasný stín na plicích – kazuistika
- Masturbační chování žen v ČR − dotazníková studie
- Úspěšná resuscitativní thorakotomie v přednemocniční neodkladné péči
- Dlouhodobá recidiva a komplikace spojené s elektivní operací břišní kýly
Najčítanejšie v tomto čísle
- A daily diary study on maladaptive daydreaming, mind wandering, and sleep disturbances: Examining within-person and between-persons relations
- A 3’ UTR SNP rs885863, a cis-eQTL for the circadian gene VIPR2 and lincRNA 689, is associated with opioid addiction
- A substitution mutation in a conserved domain of mammalian acetate-dependent acetyl CoA synthetase 2 results in destabilized protein and impaired HIF-2 signaling
- Molecular validation of clinical Pantoea isolates identified by MALDI-TOF