Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study
Abstract Background Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcomes. Predictors of poor outcomes vary in different regions. Vietnam is among the top 30 high burden of MDR-TB countries. We describe demographic characteristics and identify...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-02-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-020-4887-1 |
| _version_ | 1818552558961033216 |
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| author | Le Hong Van Phan Trieu Phu Dao Nguyen Vinh Vo Thanh Son Nguyen Thi Hanh Le Thanh Hoang Nhat Nguyen Huu Lan Truong Van Vinh Nguyen Thi Mai Trang Dang Thi Minh Ha Guy E. Thwaites Nguyen Thuy Thuong Thuong |
| author_facet | Le Hong Van Phan Trieu Phu Dao Nguyen Vinh Vo Thanh Son Nguyen Thi Hanh Le Thanh Hoang Nhat Nguyen Huu Lan Truong Van Vinh Nguyen Thi Mai Trang Dang Thi Minh Ha Guy E. Thwaites Nguyen Thuy Thuong Thuong |
| author_sort | Le Hong Van |
| collection | DOAJ |
| description | Abstract Background Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcomes. Predictors of poor outcomes vary in different regions. Vietnam is among the top 30 high burden of MDR-TB countries. We describe demographic characteristics and identify risk factors for poor outcome among patients with MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam. Methods This retrospective study included 2266 patients who initiated MDR-TB treatment between 2011 and 2015 in HCMC. Treatment outcomes were available for 2240 patients. Data was collected from standardized paper-based treatment cards and electronic records. A Kruskal Wallis test was used to assess changes in median age and body mass index (BMI) over time, and a Wilcoxon test was used to compare the median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression with multiple imputation for missing data was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program. Results Among 2266 eligible cases, 60.2% had failed on a category I or II treatment regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. The notification rate increased 24.7% from 2011 to 2015. The treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty or 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1 kg/m2 of BMI for patients with BMI < 21). Conclusion The number of patients diagnosed with MDR-TB in HCMC increased by almost a quarter between 2011 and 2015. Patients with HIV, high smear grade, malnutrition or a history of previous MDR-TB treatment are at greatest risk of poor treatment outcome. |
| first_indexed | 2024-12-12T09:14:45Z |
| format | Article |
| id | doaj.art-b4aae187361e41d181782848c43ed683 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T09:14:45Z |
| publishDate | 2020-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-b4aae187361e41d181782848c43ed6832022-12-22T00:29:25ZengBMCBMC Infectious Diseases1471-23342020-02-0120111010.1186/s12879-020-4887-1Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective studyLe Hong Van0Phan Trieu Phu1Dao Nguyen Vinh2Vo Thanh Son3Nguyen Thi Hanh4Le Thanh Hoang Nhat5Nguyen Huu Lan6Truong Van Vinh7Nguyen Thi Mai Trang8Dang Thi Minh Ha9Guy E. Thwaites10Nguyen Thuy Thuong Thuong11Tuberculosis group, Oxford University Clinical Research UnitTuberculosis group, Oxford University Clinical Research UnitTuberculosis group, Oxford University Clinical Research UnitTuberculosis group, Oxford University Clinical Research UnitTuberculosis group, Oxford University Clinical Research UnitTuberculosis group, Oxford University Clinical Research UnitPham Ngoc Thach HospitalPham Ngoc Thach HospitalPham Ngoc Thach HospitalPham Ngoc Thach HospitalTuberculosis group, Oxford University Clinical Research UnitTuberculosis group, Oxford University Clinical Research UnitAbstract Background Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcomes. Predictors of poor outcomes vary in different regions. Vietnam is among the top 30 high burden of MDR-TB countries. We describe demographic characteristics and identify risk factors for poor outcome among patients with MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam. Methods This retrospective study included 2266 patients who initiated MDR-TB treatment between 2011 and 2015 in HCMC. Treatment outcomes were available for 2240 patients. Data was collected from standardized paper-based treatment cards and electronic records. A Kruskal Wallis test was used to assess changes in median age and body mass index (BMI) over time, and a Wilcoxon test was used to compare the median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression with multiple imputation for missing data was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program. Results Among 2266 eligible cases, 60.2% had failed on a category I or II treatment regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. The notification rate increased 24.7% from 2011 to 2015. The treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty or 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1 kg/m2 of BMI for patients with BMI < 21). Conclusion The number of patients diagnosed with MDR-TB in HCMC increased by almost a quarter between 2011 and 2015. Patients with HIV, high smear grade, malnutrition or a history of previous MDR-TB treatment are at greatest risk of poor treatment outcome.http://link.springer.com/article/10.1186/s12879-020-4887-1Multidrug resistant tuberculosisRetrospectiveTreatment outcomeRisk factorsVietnam |
| spellingShingle | Le Hong Van Phan Trieu Phu Dao Nguyen Vinh Vo Thanh Son Nguyen Thi Hanh Le Thanh Hoang Nhat Nguyen Huu Lan Truong Van Vinh Nguyen Thi Mai Trang Dang Thi Minh Ha Guy E. Thwaites Nguyen Thuy Thuong Thuong Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study BMC Infectious Diseases Multidrug resistant tuberculosis Retrospective Treatment outcome Risk factors Vietnam |
| title | Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study |
| title_full | Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study |
| title_fullStr | Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study |
| title_full_unstemmed | Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study |
| title_short | Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study |
| title_sort | risk factors for poor treatment outcomes of 2266 multidrug resistant tuberculosis cases in ho chi minh city a retrospective study |
| topic | Multidrug resistant tuberculosis Retrospective Treatment outcome Risk factors Vietnam |
| url | http://link.springer.com/article/10.1186/s12879-020-4887-1 |
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