| Author | Ridolfi, Felipe | |
| Author | Peetluk, Lauren | |
| Author | Amorim, Gustavo | |
| Author | Turner, Megan | |
| Author | Figueiredo, Marina | |
| Author | Santos, Marcelo Cordeiro | |
| Author | Cavalcante, Solange | |
| Author | Kritski, Afrânio | |
| Author | Durovni, Betina | |
| Author | Andrade, Bruno | |
| Author | Sterling, Timothy R. | |
| Author | Rolla, Valeria | |
| Access date | 2022-09-29T17:09:21Z | |
| Available date | 2022-09-29T17:09:21Z | |
| Document date | 2022 | |
| Citation | RIDOLFI, Felipe et al. Tuberculosis treatment outcomes in Brazil: different predictors for each type of unsuccessful outcome. Clinical Infectious Diseases, p.1-8, Jul. 2022. | en_US |
| ISSN | 1537-6591 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/54936 | |
| Sponsorship | Departamento de Ciência e Tecnologia (DECIT). Secretaria de Ciência e Tecnologia (SCTIE). Ministério da Saúde (MS). Institutos Nacionais de Saúde. Instituto Nacional de Alergia e Doenças Infecciosas. | en_US |
| Language | eng | en_US |
| Publisher | Oxford University Press | en_US |
| Rights | restricted access | |
| MeSH | Tuberculosis | en_US |
| MeSH | Therapeutics | en_US |
| Subject in Portuguese | Tuberculose | en_US |
| Subject in Portuguese | Tratamento | en_US |
| Subject in Portuguese | Resultados | en_US |
| Subject in Portuguese | Perda de seguimento | en_US |
| Title | Tuberculosis treatment outcomes in Brazil: different predictors for each type of unsuccessful outcome | en_US |
| Type | Article | |
| DOI | 10.1093/cid/ciac541 | |
| Abstract | Background: Successful tuberculosis (TB) treatment is necessary for disease control. The World Health Organization (WHO) has a target TB treatment success rate of ≥90%. We assessed whether the different types of unfavorable TB treatment outcome had different predictors. Methods: Using data from Regional Prospective Observational Research for Tuberculosis-Brazil, we evaluated biological and behavioral factors associated with each component of unsuccessful TB outcomes, recently updated by WHO (death, loss to follow-up [LTFU], and treatment failure). We included culture-confirmed, drug-susceptible, pulmonary TB participants receiving standard treatment in 2015–2019. Multinomial logistic regression models with inverse probability weighting were used to evaluate the distinct determinants of each unsuccessful outcome. Results: Of 915 participants included, 727 (79%) were successfully treated, 118 (13%) were LTFU, 44 (5%) had treatment failure, and 26 (3%) died. LTFU was associated with current drug-use (adjusted odds ratio [aOR] = 5.3; 95% confidence interval [CI], 3.0–9.4), current tobacco use (aOR = 2.9; 95% CI, 1.7–4.9), and being a person living with HIV (PLWH) (aOR = 2.0; 95% CI, 1.1–3.5). Treatment failure was associated with PLWH (aOR = 2.7; 95% CI, 1.2–6.2) and having diabetes (aOR = 2.2; 95% CI, 1.1–4.4). Death was associated with anemia (aOR = 5.3; 95% CI, 1.4–19.7), diabetes (aOR = 3.1; 95% CI, 1.4–6.7), and PLWH (aOR = 3.9; 95% CI, 1.3–11.4). Direct observed therapy was protective for treatment failure (aOR = 0.5; 95% CI, .3–.9) and death (aOR = 0.5; 95% CI, .2–1.0). Conclusions: The treatment success rate was below the WHO target. Behavioral factors were most associated with LTFU, whereas clinical comorbidities were correlated with treatment failure and death. Because determinants of unsuccessful outcomes are distinct, different intervention strategies may be needed to improve TB outcomes. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Vanderbilt University School of Medicine. Department of Medicine. Division of Epidemiology. Nashville, Tennessee, USA. | en_US |
| Affilliation | Vanderbilt University Medical Center. Department of Biostatistics. Nashville, Tennessee, USA. | en_US |
| Affilliation | University School of Medicine. Department of Medicine, Vanderbilt. Division of Infectious Diseases. Nashville, Tennessee, USA. | en_US |
| Affilliation | University School of Medicine. Department of Medicine, Vanderbilt. Division of Infectious Diseases. Nashville, Tennessee, USA. | en_US |
| Affilliation | Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil / Universidade do Estado do Amazonas. Manaus, AM, Brasil. | en_US |
| Affilliation | Clínica de Família Rinaldo Delamare. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Presidência. Centro de Estudos Estratégicos. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | University School of Medicine. Department of Medicine, Vanderbilt. Division of Infectious Diseases. Nashville, Tennessee, USA / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Inflamação e Biomarcadores, Salvador, BA, Brasil / Translacional de Patrocínio de Rede de Organizações Multinacionais e Iniciativa de Pesquisa Epidemiológica. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Universidade Salvador. Curso de Medicina. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. Curso de Medicina. Salvador, BA, Brasil / Fundação José Silveira. Instituto Brasileiro para Investigação da Tuberculose. Salvador, BA, Brasil. | en_US |
| Affilliation | University School of Medicine. Department of Medicine, Vanderbilt. Division of Infectious Diseases. Nashville, Tennessee, USA. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Subject | Tuberculosis | en_US |
| Subject | Treatment | en_US |
| Subject | Outcomes | en_US |
| Subject | Loss-to-follow-up | en_US |
