Treatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using Brazilian surveillance system.

<h4>Background</h4>The impact of non-communicable diseases on tuberculosis incidence has received significant attention. It has been suggested that the risk of tuberculosis is higher among subjects with diabetes and these subjects also has poor TB treatment outcomes.This study was aimed...

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Autores principales:	Bárbara Reis-Santos, Teresa Gomes, Rodrigo Locatelli, Elizabete R de Oliveira, Mauro N Sanchez, Bernardo L Horta, Lee W Riley, Ethel L Maciel
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e844a3d490a8407d8e19b0f2b835693b
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spelling	oai:doaj.org-article:e844a3d490a8407d8e19b0f2b835693b2021-11-25T06:09:24ZTreatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using Brazilian surveillance system.1932-620310.1371/journal.pone.0100082https://doaj.org/article/e844a3d490a8407d8e19b0f2b835693b2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25003346/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The impact of non-communicable diseases on tuberculosis incidence has received significant attention. It has been suggested that the risk of tuberculosis is higher among subjects with diabetes and these subjects also has poor TB treatment outcomes.This study was aimed at assessing the socio-demographic and clinical factors that may influence different outcome of TB in patients with DM (TB-DM) identified in the Brazilian national database from 2001 to 2011.<h4>Methods</h4>TB-DM cases reported in the Brazilian information system were identified and compared.Covariates associated with the outcomes of interest (cure, default, deaths, and development of TB MDR) were included in a hierarchical regression model.<h4>Results</h4>TB-DM cases increased from 380/100,000/year in 2001 to 6,150/100,000/year in 2011. Some of the main associations found are pointed. The odds of default was higher among those in the age group 20-39 years (OR = 2.07, 95%CI 1.32-3.24); alcoholics (OR = 2.17, 95%CI 1.86-2.54), and HIV/AIDS (OR = 2.16, 95%CI 1.70-2.74);positive monitoring smear (OR = 1.94, 95%CI 1.55-2.43); prior default (OR = 5.41, 95%CI 4.47-6.54), and unknown type of treatment (OR = 3.33, 95%CI 1.54-7.22). The odds of death was greater for subjects ≥60 years old (OR = 2.74, 95%CI 1.74-4.29); institutionalized in shelter (OR = 2.69, 95%CI 1.07-6.77); alcoholics (OR = 2.70, 95%CI 2.27-3.22); HIV/AIDS (OR = 2.87, 95%CI 2.13-3.86); pulmonary+extrapulmonary TB (OR = 2.49, 95%CI 1.79-3.46); with unknown type of treatment (OR = 14.12, 95%CI 7.04-28.32).Development of MDR TB was more related to relapse (OR = 9.60, 95%CI 6.07-15.14);previous default (OR = 17.13, 95%CI 9.58-30.63); and transfer of treatment center (OR = 7.87, 95%CI 4.74-13.07).<h4>Conclusions</h4>Older subjects and those with comorbidities and with a previous treatment of TB had poorest outcomes. TB control program in Brazil will need to expand efforts to focus on treatment of TB-DM patients to improve their cure rates in order to achieve the goals of tuberculosis elimination.Bárbara Reis-SantosTeresa GomesRodrigo LocatelliElizabete R de OliveiraMauro N SanchezBernardo L HortaLee W RileyEthel L MacielPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e100082 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Bárbara Reis-Santos Teresa Gomes Rodrigo Locatelli Elizabete R de Oliveira Mauro N Sanchez Bernardo L Horta Lee W Riley Ethel L Maciel Treatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using Brazilian surveillance system.
description	<h4>Background</h4>The impact of non-communicable diseases on tuberculosis incidence has received significant attention. It has been suggested that the risk of tuberculosis is higher among subjects with diabetes and these subjects also has poor TB treatment outcomes.This study was aimed at assessing the socio-demographic and clinical factors that may influence different outcome of TB in patients with DM (TB-DM) identified in the Brazilian national database from 2001 to 2011.<h4>Methods</h4>TB-DM cases reported in the Brazilian information system were identified and compared.Covariates associated with the outcomes of interest (cure, default, deaths, and development of TB MDR) were included in a hierarchical regression model.<h4>Results</h4>TB-DM cases increased from 380/100,000/year in 2001 to 6,150/100,000/year in 2011. Some of the main associations found are pointed. The odds of default was higher among those in the age group 20-39 years (OR = 2.07, 95%CI 1.32-3.24); alcoholics (OR = 2.17, 95%CI 1.86-2.54), and HIV/AIDS (OR = 2.16, 95%CI 1.70-2.74);positive monitoring smear (OR = 1.94, 95%CI 1.55-2.43); prior default (OR = 5.41, 95%CI 4.47-6.54), and unknown type of treatment (OR = 3.33, 95%CI 1.54-7.22). The odds of death was greater for subjects ≥60 years old (OR = 2.74, 95%CI 1.74-4.29); institutionalized in shelter (OR = 2.69, 95%CI 1.07-6.77); alcoholics (OR = 2.70, 95%CI 2.27-3.22); HIV/AIDS (OR = 2.87, 95%CI 2.13-3.86); pulmonary+extrapulmonary TB (OR = 2.49, 95%CI 1.79-3.46); with unknown type of treatment (OR = 14.12, 95%CI 7.04-28.32).Development of MDR TB was more related to relapse (OR = 9.60, 95%CI 6.07-15.14);previous default (OR = 17.13, 95%CI 9.58-30.63); and transfer of treatment center (OR = 7.87, 95%CI 4.74-13.07).<h4>Conclusions</h4>Older subjects and those with comorbidities and with a previous treatment of TB had poorest outcomes. TB control program in Brazil will need to expand efforts to focus on treatment of TB-DM patients to improve their cure rates in order to achieve the goals of tuberculosis elimination.
format	article
author	Bárbara Reis-Santos Teresa Gomes Rodrigo Locatelli Elizabete R de Oliveira Mauro N Sanchez Bernardo L Horta Lee W Riley Ethel L Maciel
author_facet	Bárbara Reis-Santos Teresa Gomes Rodrigo Locatelli Elizabete R de Oliveira Mauro N Sanchez Bernardo L Horta Lee W Riley Ethel L Maciel
author_sort	Bárbara Reis-Santos
title	Treatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using Brazilian surveillance system.
title_short	Treatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using Brazilian surveillance system.
title_full	Treatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using Brazilian surveillance system.
title_fullStr	Treatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using Brazilian surveillance system.
title_full_unstemmed	Treatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using Brazilian surveillance system.
title_sort	treatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using brazilian surveillance system.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/e844a3d490a8407d8e19b0f2b835693b
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Treatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using Brazilian surveillance system.

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