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Treatment outcomes of drug resistant tuberculosis patients with multiple poor prognostic indicators in Uganda: A countrywide 5-year retrospective study
- Source :
- Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, Vol 23, Iss, Pp 100221-(2021)
- Publication Year :
- 2021
- Publisher :
- Elsevier, 2021.
-
Abstract
- Background: Comorbid conditions and adverse drug events are associated with poor treatment outcomes among patients with drug resistant tuberculosis (DR – TB). This study aimed at determining the treatment outcomes of DR – TB patients with poor prognostic indicators in Uganda. Methods: We reviewed treatment records of DR – TB patients from 16 treatment sites in Uganda. Eligible patients had confirmed DR – TB, a treatment outcome in 2014–2019 and at least one of 15 pre-defined poor prognostic indicators at treatment initiation or during therapy. The pre-defined poor prognostic indicators were HIV co-infection, diabetes, heart failure, malignancy, psychiatric illness/symptoms, severe anaemia, alcohol use, cigarette smoking, low body mass index, elevated creatinine, hepatic dysfunction, hearing loss, resistance to fluoroquinolones and/or second-line aminoglycosides, previous exposure to second-line drugs (SLDs), and pregnancy. Tuberculosis treatment outcomes were treatment success, mortality, loss to follow up, and treatment failure as defined by the World Health Organisation. We used logistic and cox proportional hazards regression analysis to determine predictors of treatment success and mortality, respectively. Results: Of 1122 DR – TB patients, 709 (63.2%) were male and the median (interquartile range, IQR) age was 36.0 (28.0–45.0) years. A total of 925 (82.4%) had ≥2 poor prognostic indicators. Treatment success and mortality occurred among 806 (71.8%) and 207 (18.4%) patients whereas treatment loss-to-follow-up and failure were observed among 96 (8.6%) and 13 (1.2%) patients, respectively. Mild (OR: 0.57, 95% CI 0.39–0.84, p = 0.004), moderate (OR: 0.18, 95% CI 0.12–0.26, p
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Tuberculosis
030106 microbiology
MDR-TB
Drug resistance
Infectious and parasitic diseases
RC109-216
Outcomes
Drug resistant
Article
03 medical and health sciences
Diseases of the respiratory system
0302 clinical medicine
Interquartile range
Internal medicine
Diabetes mellitus
medicine
Risk of mortality
030212 general & internal medicine
Poor prognostic indicators
Prospective cohort study
Pregnancy
RC705-779
business.industry
Retrospective cohort study
medicine.disease
Treatment success
Infectious Diseases
business
Subjects
Details
- Language :
- English
- ISSN :
- 24055794
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
- Accession number :
- edsair.doi.dedup.....92284108f787432b236c5f489cc94904