Risk factors to unfavorable treatment outcomes in patients with drug resistance tuberculosis admitted at a tertiary referral hospital in Rio de Janeiro State

Authors

DOI:

https://doi.org/10.33448/rsd-v11i15.37419

Keywords:

Tuberculosis; Treatment Outcome; Risk Factors; Drug Resistance; Case-control studies.

Abstract

This study aims at identifying clinical and demographic factors associated with DR-TB and unfavorable outcomes in a reference TB hospital in Rio de Janeiro State. We performed a retrospective case-control study with presumed DR-TB inpatients hospitalized from 2011 to 2014. DR-TB patients were the case group, and drug-sensitive (DS)-TB, the control group. Logistic regressions were performed to analyze the risk factors associated with DR-TB and the outcomes. Among 135 patients, DR was detected in 41.5%. Being an illegal drug user and having previous TB treatment were associated with DR-TB. Being Afro-Brazilian, male, and under 40 years old were associated with unfavorable outcomes. Patients with rifampicin and isoniazid resistance had 9.7-fold higher odds to death. In conclusion, the high proportion of patients with resistance detected in a tertiary hospital and the poor general condition point to failures in the primary health care that contribute to the proportion of unfavorable outcome.

Author Biography

Marcia Maria Freire, Universidade Federal do Rio de Janeiro

Possui Graduação em Medicina pela Universidade Iguaçu (1987). . Internato pela Universidade Federal do Estado do Rio de janeiro - UNI-RIO . Residência em Clínica Médica IASERJ . Pós-graduação em Pneumologia pela Universidade Federal do Estado do Rio de janeiro - UNI-RIO . Título de Especialista em Pneumologia pela Sociedade Brasileira de Pneumologia e Tisiologia e Associação Médica Brasileira . Mestrado em Medicina, área de concentração: Clínica Médica - Pneumologia . Estágios na área de Pneumologia na Alemanha e Portugal . Certificação em Espirometria pela Sociedade Brasileira de Pneumologia e Tisiologia/Associação Médica Brasileira . Membro das Sociedades médicas: Sociedade brasileira de Pneumologia e Tisiologia, Sociedade de Pneumologia e Tisiologia do Rio de Janero, European Respiratory Society, American Thoracic Society e de Word Association for Bronchologie . Médica Pneumologista da Secretaria de Saúde do Estado do Rio de Janeiro Especialidade de Pneumologia - exercício no Hospital Estadual Santa Maria . Concursos públicos: . 4 º Lugar no Concurso Público realizado em dezembro de 1990. Publicado em Diário Oficial. Contratada desde março de 1991, Lotada no Hospital Estadual Santa Maria . 16 º Lugar no Concurso Público para o Hospital do IASERJ na Especialidade de Pneumologia. Realizado em fevereiro de 1991 . Professora Substituto de Pneumologia pela UFRJ. 2018 - 2019

References

Bartholomay, P., Pinheiro, R.S., Johansen, F.D.C., De Oliveira, S.B., Rocha, M.S., Pelissari, D.M. et al. (2020) Gaps in drug-resistant tuberculosis surveillance: Probabilistic database linkage in Brazil. Cad Saúde Pública,36(5):1–13.

Bhering, M., Duarte, R., Kritski, A. (2019a). Predictive factors for unfavourable treatment in MDR-TB and XDR-TB patients in Rio de Janeiro State, Brazil, 2000-2016. Plos One.14(11):e0218299.

Bhering, M., Kritski, A., Nunes, C., Duarte, R. (2019b). Multidrug-resistant tuberculosis in Lisbon: unfavourable treatment and associated factors, 2000-2014. Int J Tuberc Lung Dis,23(10):1075-1081.

Brasil (2003). Ministério da Saúde. Secretaria Executiva. Coordenação Nacional de DST/Aids.(2003). A Política do Ministério da Saúde para atenção integral a usuários de álcool e outras drogas. Secretaria Executiva, Coordenação Nacional de DST e Aids. Brasília: Ministério da Saúde.

Brasil (2019). Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância Epidemiológica. Manual de recomendações para controle da tuberculose no Brasil. Brasília: Ministério da Saúde –2ª Edição Atualizada. Brasília: Ministério da Saúde.

Brasil (2021). Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância Epidemiológica (2021). Boletim Epidemiológico Tuberculose. Brasília: Ministério da Saúde, 43p.

Caminero, J.A., Van Deum, A., Fujiwara, P.I. (2013). Guidelines for clinical and operational management of drug-resistant tuberculosis. Paris, France: International Union Against Tuberculosis and Lung Disease.

Chung-Delgado, K., Guillern-Bravo, S., Revilla-Montag, A, Bernabe-Ortiz, A. (2015). Mortality among MDR-TB cases: comparison with Drug-Susceptible Tuberculosis and Associated Factors. Plos One,10(3):e0119332.

Faustini A., Hall, A.J., Perucci, C.A. (2006). Risk Factors for multidrug resistant tuberculosis in Europe: a systematic review. Thorax;61(2):158-63.

Fregona, G., Cosme, L.B., Moreira, C.M.M., Bussular, J.L., Dettoni, V.V., Dalcolmo, M.P. et al. (2017). Risk factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. Rev Saúde Pública, 51:41.

Gayoso, R., Dalcolmo, M., Braga, J.U., Barreira, D. (2018) Predictors of mortality in multidrug-resistant tuberculosis patients from Brazilian reference centers, 2005-2012. Braz J Infect Dis.,22(4):305-10.

Günther, G., Van Leth, F., Alexandru, S., Altet, N., Avsar, K., Bang, D. et al. (2015). Multidrug-resistant tuberculosis in Europe, 2010-2011. Emerging Infectious Disease, 21(3):409-16.

Liu, C. H., Li, L., Chen, Z., Wang, Q., Hu, Y. L., Zhu, B., Woo, P.C.Y. (2011). Characteristics and Treatment Outcomes of Patients with MDR and XDR Tuberculosis in a TB Referral Hospital in Beijing: A 13-Year Experience. Plos One,6(4)e19399.

Medronho, R., Carvalho, D.M., Bloch, K.V., Luiz, R.R., Werneck, G.L. (2008). Epidemiologia. São Paulo: Atheneu.

Micheletti, V.C.D., Kritski, A.L., Braga, J.U. (2016). Clinical Features and Treatment Outcomes of Patients with Drug-Resistant and Drug-Sensitive Tuberculosis: A Historical Cohort Study in Porto Alegre, Brazil. Plos One,11(8):e0160109.

Nair, D., Velayutham, B., Kannan, T., Tripathy, J. P., Harries, A.D., Natrajan, M. et al. (2017). Predictors of unfavourable treatment outcomes in patients with multidrug-resistant tuberculosis in India. PHA;7(1):32-38.

Oliveira, H.M.M.G., Brito, R.C., Kritski, A. L., Ruffino Netto, A. (2009). Epidemiological profile of hospitalized patients with TB at referral hospital in the city of Rio de Janeiro, Brasil. J Bras Pneumol,35(8):780-787.

Paula, H.C. de, Aguiar, A.C. de (2013) 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,192–204.

Polu, G.P., Mohammad Shaik, J., Kota, N.M.K., Karumanchi, D., Allam, U.S. (2019). Analysis of drug resistance mutations in pulmonary Mycobacterium tuberculosis isolates in the Southern coastal region of Andhra Pradesh, India. Braz J Infect Dis,23(5):281-290.

Pradipta, I.S., Forsman, L.D., Bruchfeld, J., Hak, E., Alffenaar, J.W. (2018). Risk factors of multidrug-resistant tuberculosis: A global systematic review and meta-analysis. Journal of Infection,77:469-478.

Ramalho, D.M.P., Miranda, P.F.C., Andrade, M.K., Dalcolmo, M.P., Mesquita, E., Dias, C.F. et al (2017). Outcomes from patients with presumed drug resistant tuberculosis in five reference centers in Brazil. BMC Infec Dis,17(1):571-584.

Sá, A.M.M., Santiago, L.A., Santos, N.V., Monteiro, N.P., Pinto, P.H.A., Lima, A.M., Iwasaka-Neder, P.L. (2017). Causas de abandono do tratamento entre portadores de tuberculose. Rev Soc Bras Clin Med,15(3):155-60.

Silva, D.R., Muñoz-Torrico, M., Duarte, R., Galvão, T., Bonini, E.H., Arbex, F.F. (2018). Fatores de risco para tuberculose: diabetes, tabagismo, álcool e uso de outras drogas. J Bras Pneum. 44(2):145–52.

Silva, M.L.B., Durovini, P., Mota, P., Kritsk, A.L. (2021). Fatores associados à subnotificação de casos de tuberculose multirresistente no Estado do Rio de Janeiro, Brasil: relacionamento probabilístico entre sistemas de informação. Cad Saúde Pública,37(10):e00293920.

Tamuzi, J.L., Ayele, B.T., Shumba, C.S., Adetokunboh, O.O., Uwimana-Nicol, J., Haile, Z.T. et al. (2020). Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence. BMC Infect Dis,20:744.

Ullah, I., Javaid, A., Zarfishan, T., Ullah, O., Shah, A.A., Hasan, F., Ayub, N. (2016). Pattern of Drug Resistance and Risk factors Associated with Development of Drug Resistant Mycobacterium Tuberculosis in Pakistan. Plos One;11(1):e0147529.

UNODC (2020). United Nations Office on Drug and Crime. World Drug Report 2020. Vienna – Austria: United Nations Office on Drug and Crime.

WHO (2014). World Health Organization. Companion handbook to the WHO guidelines for the programmatic management of drug-resistant tuberculosis. The end TB Strategy. Geneva: World Health Organization

WHO (2015). World Health Organization. Global Tuberculosis Report 2015. Geneva: World Health Organization.

WHO (2020). World Health Organization. Global Tuberculosis Report 2020. Geneva: World Health Organization.

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Published

25/11/2022

How to Cite

FREIRE, M. M.; BHERING, M.; RUFFINO NETTO, A.; KRITSKI, A. L. . Risk factors to unfavorable treatment outcomes in patients with drug resistance tuberculosis admitted at a tertiary referral hospital in Rio de Janeiro State. Research, Society and Development, [S. l.], v. 11, n. 15, p. e529111537419, 2022. DOI: 10.33448/rsd-v11i15.37419. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/37419. Acesso em: 26 dec. 2024.

Issue

Vol. 11 No. 15

Section

Health Sciences

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Copyright (c) 2022 Marcia Maria Freire; Marcela Bhering; Antônio Ruffino Netto; Afrânio Linei Kritski

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