B Reis-Santos1, I Pellacani-Posses1, L R Macedo1, J E Golub2, L W Riley3, E L Maciel1. 1. Lab-Epi Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil. 2. School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. 3. Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, California, USA.
Abstract
SETTING: All Brazilian states. OBJECTIVES: To assess the determinants of tuberculosis (TB) in patients undergoing directly observed therapy (DOT) and the impact of DOT on treatment outcomes. DESIGN: This is a cross-sectional study among TB patients aged ⩾18 years conducted in 2011. The primary outcome was the status of DOT received, while the secondary was the outcome of anti-tuberculosis treatment. RESULTS: In 2011, 35 775 (38.3%) subjects received DOT. The odds of receiving DOT were higher in patients with the following characteristics: brown/mestizo patients (OR 1.18, 95%CI 1.14-1.22) and those of other ethnic groups (OR 2.01, 95%CI 1.79-2.27) compared to Whites, alcohol users (OR 1.37, 95%CI 1.28-1.47) and those with mental disorders (OR 1.88, 95%CI 1.54-2.29). The odds of receiving DOT were lower in human immunodeficiency virus positive patients (OR 0.64, 95%CI 0.60-0.68). Patients who did not receive DOT were more likely to default from anti-tuberculosis treatment (OR 0.62, 95%CI 0.57-0.66), die due to TB (OR 0.68, 95%CI 0.61-0.77) and to have unknown treatment outcomes (OR 0.71, 95%CI 0.66-0.76). The adjusted preventable fraction of DOT in the reduction of unfavorable outcomes was 25%. CONCLUSION: Sociodemographic and clinical characteristics are determinants of anti-tuberculosis treatment outcomes in patients undergoing DOT; DOT use led to a 25% reduction in unfavorable outcomes.
SETTING: All Brazilian states. OBJECTIVES: To assess the determinants of tuberculosis (TB) in patients undergoing directly observed therapy (DOT) and the impact of DOT on treatment outcomes. DESIGN: This is a cross-sectional study among TB patients aged ⩾18 years conducted in 2011. The primary outcome was the status of DOT received, while the secondary was the outcome of anti-tuberculosis treatment. RESULTS: In 2011, 35 775 (38.3%) subjects received DOT. The odds of receiving DOT were higher in patients with the following characteristics: brown/mestizo patients (OR 1.18, 95%CI 1.14-1.22) and those of other ethnic groups (OR 2.01, 95%CI 1.79-2.27) compared to Whites, alcohol users (OR 1.37, 95%CI 1.28-1.47) and those with mental disorders (OR 1.88, 95%CI 1.54-2.29). The odds of receiving DOT were lower in human immunodeficiency virus positive patients (OR 0.64, 95%CI 0.60-0.68). Patients who did not receive DOT were more likely to default from anti-tuberculosis treatment (OR 0.62, 95%CI 0.57-0.66), die due to TB (OR 0.68, 95%CI 0.61-0.77) and to have unknown treatment outcomes (OR 0.71, 95%CI 0.66-0.76). The adjusted preventable fraction of DOT in the reduction of unfavorable outcomes was 25%. CONCLUSION: Sociodemographic and clinical characteristics are determinants of anti-tuberculosis treatment outcomes in patients undergoing DOT; DOT use led to a 25% reduction in unfavorable outcomes.
Authors: Payam Nahid; Susan E Dorman; Narges Alipanah; Pennan M Barry; Jan L Brozek; Adithya Cattamanchi; Lelia H Chaisson; Richard E Chaisson; Charles L Daley; Malgosia Grzemska; Julie M Higashi; Christine S Ho; Philip C Hopewell; Salmaan A Keshavjee; Christian Lienhardt; Richard Menzies; Cynthia Merrifield; Masahiro Narita; Rick O'Brien; Charles A Peloquin; Ann Raftery; Jussi Saukkonen; H Simon Schaaf; Giovanni Sotgiu; Jeffrey R Starke; Giovanni Battista Migliori; Andrew Vernon Journal: Clin Infect Dis Date: 2016-08-10 Impact factor: 9.079
Authors: Barbara Reis-Santos; Priya Shete; Adelmo Bertolde; Carolina M Sales; Mauro N Sanchez; Denise Arakaki-Sanchez; Kleydson B Andrade; M Gabriela M Gomes; Delia Boccia; Christian Lienhardt; Ethel L Maciel Journal: PLoS One Date: 2019-02-22 Impact factor: 3.240