Risk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting

Background: Risk factors for mortality and MDR-TB in Guatemala are poorly understood. We aimed to identify risk factors to assist in targeting public health interventions. Methods: We performed a retrospective study of adults with pulmonary TB reported to the Guatemalan TB Program between January 1,...

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Autores principales:	Kevin Montes, Himachandana Atluri, Hibeb Silvestre Tuch, Lucrecia Ramirez, Juan Paiz, Ana Hesse Lopez, Thomas C. Bailey, Andrej Spec, Carlos Mejia-Chew
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Mortality MDR-TB Risk factors Central America Guatemala Diseases of the respiratory system RC705-779 Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/db163199127d4b4aac1a629aeefe45a8
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spelling	oai:doaj.org-article:db163199127d4b4aac1a629aeefe45a82021-11-22T04:27:23ZRisk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting2405-579410.1016/j.jctube.2021.100287https://doaj.org/article/db163199127d4b4aac1a629aeefe45a82021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2405579421000760https://doaj.org/toc/2405-5794Background: Risk factors for mortality and MDR-TB in Guatemala are poorly understood. We aimed to identify risk factors to assist in targeting public health interventions. Methods: We performed a retrospective study of adults with pulmonary TB reported to the Guatemalan TB Program between January 1, 2016 and December 31, 2017. The primary objective was to determine risk factors for mortality in pulmonary TB. The secondary objective was to determine risk factors associated with MDR-TB. Results: Among 3,945 patients with pulmonary TB, median age was 39 years (IQR 25–54), 59% were male, 25% of indigenous ethnicity, 1.1% had MDR-TB and 3.9% died. On multivariable analysis, previous TB treatment (odds ratio [OR] 3.57, CI 2.24–5.68 [p < 0.001]), living with HIV (OR 3.98, CI 2.4–6.17 [p < 0.001]), unknown HIV diagnosis (OR 2.65, CI 1.68–4.18 [p < 0.001]), indigenous ethnicity (OR 1.79, CI 1.18–2.7 [p = 0.005]), malnutrition (OR 7.33, CI 3.24–16.59 [p < 0.001]), and lower educational attainment (OR 2.86, CI 1.43–5.88 [p = 0.003]) were associated with mortality. Prior treatment (OR 53.76, CI 25.04–115.43 [p < 0.001]), diabetes (OR 4.13, CI 2.04–8.35 [p < 0.001]), and indigenous ethnicity (OR 11.83, CI 1.46–95.73 [p = 0.02]) were associated with MDR-TB. Conclusions: In Guatemala, both previous TB treatment and indigenous ethnicity were associated with higher TB mortality and MDR-TB risk among patients with pulmonary TB.Kevin MontesHimachandana AtluriHibeb Silvestre TuchLucrecia RamirezJuan PaizAna Hesse LopezThomas C. BaileyAndrej SpecCarlos Mejia-ChewElsevierarticleMortalityMDR-TBRisk factorsCentral AmericaGuatemalaDiseases of the respiratory systemRC705-779Infectious and parasitic diseasesRC109-216ENJournal of Clinical Tuberculosis and Other Mycobacterial Diseases, Vol 25, Iss , Pp 100287- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Mortality MDR-TB Risk factors Central America Guatemala Diseases of the respiratory system RC705-779 Infectious and parasitic diseases RC109-216
spellingShingle	Mortality MDR-TB Risk factors Central America Guatemala Diseases of the respiratory system RC705-779 Infectious and parasitic diseases RC109-216 Kevin Montes Himachandana Atluri Hibeb Silvestre Tuch Lucrecia Ramirez Juan Paiz Ana Hesse Lopez Thomas C. Bailey Andrej Spec Carlos Mejia-Chew Risk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting
description	Background: Risk factors for mortality and MDR-TB in Guatemala are poorly understood. We aimed to identify risk factors to assist in targeting public health interventions. Methods: We performed a retrospective study of adults with pulmonary TB reported to the Guatemalan TB Program between January 1, 2016 and December 31, 2017. The primary objective was to determine risk factors for mortality in pulmonary TB. The secondary objective was to determine risk factors associated with MDR-TB. Results: Among 3,945 patients with pulmonary TB, median age was 39 years (IQR 25–54), 59% were male, 25% of indigenous ethnicity, 1.1% had MDR-TB and 3.9% died. On multivariable analysis, previous TB treatment (odds ratio [OR] 3.57, CI 2.24–5.68 [p < 0.001]), living with HIV (OR 3.98, CI 2.4–6.17 [p < 0.001]), unknown HIV diagnosis (OR 2.65, CI 1.68–4.18 [p < 0.001]), indigenous ethnicity (OR 1.79, CI 1.18–2.7 [p = 0.005]), malnutrition (OR 7.33, CI 3.24–16.59 [p < 0.001]), and lower educational attainment (OR 2.86, CI 1.43–5.88 [p = 0.003]) were associated with mortality. Prior treatment (OR 53.76, CI 25.04–115.43 [p < 0.001]), diabetes (OR 4.13, CI 2.04–8.35 [p < 0.001]), and indigenous ethnicity (OR 11.83, CI 1.46–95.73 [p = 0.02]) were associated with MDR-TB. Conclusions: In Guatemala, both previous TB treatment and indigenous ethnicity were associated with higher TB mortality and MDR-TB risk among patients with pulmonary TB.
format	article
author	Kevin Montes Himachandana Atluri Hibeb Silvestre Tuch Lucrecia Ramirez Juan Paiz Ana Hesse Lopez Thomas C. Bailey Andrej Spec Carlos Mejia-Chew
author_facet	Kevin Montes Himachandana Atluri Hibeb Silvestre Tuch Lucrecia Ramirez Juan Paiz Ana Hesse Lopez Thomas C. Bailey Andrej Spec Carlos Mejia-Chew
author_sort	Kevin Montes
title	Risk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting
title_short	Risk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting
title_full	Risk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting
title_fullStr	Risk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting
title_full_unstemmed	Risk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting
title_sort	risk factors for mortality and multidrug resistance in pulmonary tuberculosis in guatemala: a retrospective analysis of mandatory reporting
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/db163199127d4b4aac1a629aeefe45a8
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Risk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting

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