دورية أكاديمية
أعرض في EDS

Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study.

التفاصيل البيبلوغرافية
العنوان: Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study.
المؤلفون: 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.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Thuong NTT; Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam. thuongntt@oucru.org.
المصدر: BMC infectious diseases [BMC Infect Dis] 2020 Feb 22; Vol. 20 (1), pp. 164. Date of Electronic Publication: 2020 Feb 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: 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/epidemiology
مستخلص: 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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معلومات مُعتمدة: United Kingdom WT_ Wellcome Trust; 206724/Z/17/Z United Kingdom WT_ Wellcome Trust; 106680/B/14/Z United Kingdom WT_ Wellcome Trust
فهرسة مساهمة: Keywords: Multidrug resistant tuberculosis; Retrospective; Risk factors; Treatment outcome; Vietnam
تواريخ الأحداث: Date Created: 20200224 Date Completed: 20200505 Latest Revision: 20240329
رمز التحديث: 20240329
مُعرف محوري في PubMed: PMC7036193
DOI: 10.1186/s12879-020-4887-1
PMID: 32087682
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2334
DOI:10.1186/s12879-020-4887-1