Comparison of characteristics and mortality in multidrug resistant MDR and non-MDR tuberculosis patients in ChinaReportar como inadecuado




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BMC Public Health

, 15:1027

First Online: 06 October 2015Received: 11 May 2015Accepted: 22 September 2015DOI: 10.1186-s12889-015-2327-8

Cite this article as: Sun, Y., Harley, D., Vally, H. et al. BMC Public Health 2015 15: 1027. doi:10.1186-s12889-015-2327-8

Abstract

BackgroundWe conducted a cohort study to compare the characteristics of MDR-TB with non-MDR-TB patients and to measure long term 9-year mortality rate and determine factors associated with death in China.

MethodsWe reviewed the medical records of 250 TB cases from a 2001 survey to compare 100 MDR-TB patients with 150 non-MDR-TB patients who were treated in 2001-2002. Baseline attributes extracted from the records were compared between the two cohorts and long-term mortality and risk factors were determined at nine-year follow-up in 2010.

ResultsAmong the 234 patients successfully followed up, 63 26.9% were female and 171 73.1 % were male. MDR-TB patients had poorer socioeconomic status compared to non-MDRTB. Nine years after the diagnosis of TB, 69 or 29.5 % of the 234 patients had died 32 or 21.6 % of non-MDR-TB versus 37 or 43.0 % of MDR-TB and the overall mortality rate was 39-1000 per year PY 27-1000 PY among non-MDR versus 63-1000 PY among MDR-TB. Factors associated with death included: MDR status hazard ratio HR: 1.86; CI: 1.09-3.13, limited education of primary school or lower HR: 2.51; CI 1.34-4.70 and received TB treatment during the nine-year period HR 1.82; 95 % CI 1.02-3.26.

ConclusionsMDR-TB was a strong predictor for poor long-term outcome. High quality diagnosis and treatment must be ensured. Greater reimbursement or free treatment may be needed to provide access for the poor and vulnerable populations, and to increase treatment compliance.

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Autor: Yanni Sun - David Harley - Hassan Vally - Adrian Sleigh

Fuente: https://link.springer.com/







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