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dc.contributor.authorChung Delgado, Kocfaes_PE
dc.contributor.authorGuillen Bravo, Soniaes_PE
dc.contributor.authorRevilla Montag, Alejandroes_PE
dc.contributor.authorBernabe-Ortiz, Antonioes_PE
dc.date.accessioned2015-02-14T15:02:23Zes_PE
dc.date.available2015-02-14T15:02:23Zes_PE
dc.date.issued2015-02-14es_PE
dc.identifier.citation10.1371/journal.pone.0119332es_PE
dc.identifier.citation1. Chung-Delgado K, Guillen-Bravo S, Revilla-Montag A, Bernabe-Ortiz A. Mortality among MDR-TB Cases: Comparison with Drug-Susceptible Tuberculosis and Associated Factors. Caylà JA, editor. PLoS One [Internet]. 2015 Mar 19 [cited 2017 Jun 12];10(3):e0119332. Available from: http://dx.plos.org/10.1371/journal.pone.0119332es_PE
dc.identifier.urihttp://hdl.handle.net/10757/344468es_PE
dc.descriptionkocfachung@gmail.comes_PE
dc.descriptionsoniaguillenb@gmail.comes_PE
dc.descriptionarmrons@gmail.comes_PE
dc.descriptionArtículo de revista que fue aceptada para publicación en la Revista PLOS ONE el 03 de Febrero de 2015.es_PE
dc.description.abstractBackground: An increase in multidrug-resistant tuberculosis (MDR-TB) cases is evident worldwide. Its management implies a complex treatment, high costs, more toxic anti-tuberculosis drug use, longer treatment time and increased treatment failure and mortality. The aims of this study were to compare mortality between MDR and drug-susceptible cases of tuberculosis, and to determine risk factors associated with mortality among MDR-TB cases. Methods and Results: A retrospective cohort study was performed using data from clinical records of the National Strategy for Prevention and Control of Tuberculosis in Lima, Peru. In the first objective, MDR-TB, compared to drug-susceptible cases, was the main exposure variable and time to death, censored at 180 days, the outcome of interest. For the second objective, different variables obtained from clinical records were assessed as potential risk factors for death among MDR-TB cases. Cox regression analysis was used to determine hazard ratios (HR) and 95% confidence intervals (95%CI). A total of 1,232 patients were analyzed: mean age 30.9 ±14.0 years, 60.0% were males. 61 patients (5.0%) died during treatment, whereas the MDR-TB prevalence was 19.2%. MDR-TB increased the risk of death during treatment (HR=7.5; IC95%: 4.1–13.4) when compared to presumed drug-susceptible cases after controlling for potential confounders. Education level (p=0.01), previous TB episodes (p<0.001), diabetes history (p<0.001) and HIV infection (p=0.04) were factors associated with mortality among MDR-TB cases. Conclusions: MDR-TB is associated with an increased risk of death during treatment. Lower education, greater number of previous TB episodes, diabetes history, and HIV infection were independently associated with mortality among MDR-TB cases. New strategies for appropriate MDR-TB detection and management should be implemented, including drug sensitivity tests, diabetes and HIV screening, as well as guarantee for a complete adherence to therapy.
dc.formatapplication/pdfes_PE
dc.language.isoenges_PE
dc.publisherPLoS ONEes_PE
dc.rightsinfo:eu-repo/semantics/openAccesses_PE
dc.sourceUniversidad Peruana de Ciencias Aplicadas (UPC)es_PE
dc.sourceRepositorio Académico - UPCes_PE
dc.subjectTuberculosises_PE
dc.subjectMortalidades_PE
dc.titleMortality Among MDR-TB Cases: Comparison with Drug-Susceptible Tuberculosis and Associated Factorses_PE
dc.title.alternativeTuberculosis sensible y drogorresistente: Mortalidad y sus factores asociadoses_PE
dc.typeinfo:eu-repo/semantics/articlees_PE
dc.identifier.eissn1932-6203es_PE
dc.identifier.journalPLoS ONEes_PE
refterms.dateFOA2018-06-16T13:19:47Z
html.description.abstractBackground: An increase in multidrug-resistant tuberculosis (MDR-TB) cases is evident worldwide. Its management implies a complex treatment, high costs, more toxic anti-tuberculosis drug use, longer treatment time and increased treatment failure and mortality. The aims of this study were to compare mortality between MDR and drug-susceptible cases of tuberculosis, and to determine risk factors associated with mortality among MDR-TB cases. Methods and Results: A retrospective cohort study was performed using data from clinical records of the National Strategy for Prevention and Control of Tuberculosis in Lima, Peru. In the first objective, MDR-TB, compared to drug-susceptible cases, was the main exposure variable and time to death, censored at 180 days, the outcome of interest. For the second objective, different variables obtained from clinical records were assessed as potential risk factors for death among MDR-TB cases. Cox regression analysis was used to determine hazard ratios (HR) and 95% confidence intervals (95%CI). A total of 1,232 patients were analyzed: mean age 30.9 ±14.0 years, 60.0% were males. 61 patients (5.0%) died during treatment, whereas the MDR-TB prevalence was 19.2%. MDR-TB increased the risk of death during treatment (HR=7.5; IC95%: 4.1–13.4) when compared to presumed drug-susceptible cases after controlling for potential confounders. Education level (p=0.01), previous TB episodes (p<0.001), diabetes history (p<0.001) and HIV infection (p=0.04) were factors associated with mortality among MDR-TB cases. Conclusions: MDR-TB is associated with an increased risk of death during treatment. Lower education, greater number of previous TB episodes, diabetes history, and HIV infection were independently associated with mortality among MDR-TB cases. New strategies for appropriate MDR-TB detection and management should be implemented, including drug sensitivity tests, diabetes and HIV screening, as well as guarantee for a complete adherence to therapy.


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