Clinical Features and Treatment Outcomes of Patients with Drug-Resistant and Drug- Sensitive Tuberculosis: A Historical Cohort Study in Porto Alegre, Brazil

thumbnail.default.alt
Data
2016
Autores
Micheletti, Vania Celina Dezoti
Kritski, Afrânio Lineu
Braga, José Ueleres
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS ONE
Resumo
Purpose To evaluate the clinical features and treatment outcomes of patients with pulmonary tuber- culosis, stratified by level of drug resistance. Methods This was a historical cohort study based on data from the II National Anti-Tuberculosis Drug Resistance Survey (2006–2007) collected at eight participating health care facilities in Porto Alegre, southern Brazil. The cohort was followed for 3 years after the start of treatment. Results Of 299 cases of smear-positive pulmonary tuberculosis included in the study, 216 (72.2%) were diagnosed at five public primary health care units and 83 (27.8%) at three public hospi- tals. Among these cases, the prevalence of drug-resistant tuberculosis was 14.4%, and that of multidrug-resistant tuberculosis was 4.7%. Overall, 32.0% of drug-resistant and 2.0% of multidrug-resistant cases occurred in previously treated patients. The most common comor- bidity in the sample was HIV infection (26.2%). There was no association between drug- resistant or multidrug-resistant tuberculosis and sociodemographic variables. Cure was achieved in 66.7% of patients, and the default rate was 21.2%. The 2-month sputum conver- sion rate was 34.2%, and the relapse rate was 16.9%. Patients with drug-resistant tubercu- losis had lower rates of cure (45.2%) and 2-month sputum conversion (25%), as well as a higher relapse rate (30.7%). Conclusion These results highlight the urgent need for a more effective TB control program in this geo- graphical setting, with a major emphasis on treatment of drug-resistant and multidrug-resis- tant tuberculosis.
Description
Palavras-chave
Adult, Aged, Aged, 80 and over, Antitubercular Agents / pharmacology, Antitubercular Agents / therapeutic use*, Brazil / epidemiology, Cohort Studies, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Treatment Outcome, Tuberculosis, Multidrug-Resistant / drug therapy*, Tuberculosis, Pulmonary / drug therapy*.
Citação
Micheletti VC, Kritski AL, Braga JU. Clinical Features and Treatment Outcomes of Patients with Drug-Resistant and Drug-Sensitive Tuberculosis: A Historical Cohort Study in Porto Alegre, Brazil. PLoS One. 2016 Aug 9;11(8):e0160109. doi: 10.1371/journal.pone.0160109.