Treatment outcome and mortality among patients with multidrug-resistant tuberculosis in tuberculosis hospitals of the public sector - PubMed (original) (raw)

Treatment outcome and mortality among patients with multidrug-resistant tuberculosis in tuberculosis hospitals of the public sector

Doo Soo Jeon et al. J Korean Med Sci. 2011 Jan.

Abstract

This study was conducted to evaluate treatment outcome, mortality, and predictors of both in patients with multidrug-resistant tuberculosis (MDR-TB) at 3 TB referral hospitals in the public sector of Korea. We included MDR-TB patients treated at 3 TB referral hospitals in 2004 and reviewed retrospectively their medical records and mortality data. Of 202 MDR-TB patients, 75 (37.1%) had treatment success and 127 (62.9%) poor outcomes. Default rate was high (37.1%, 75/202), comprising 59.1% of poor outcomes. Male sex (adjusted odds ratio [aOR], 2.91; 95% confidence interval [CI], 1.13-7.49), positive smear at treatment initiation (aOR, 5.50; 95% CI, 1.22-24.90), and extensively drug-resistant TB (aOR, 10.72; 95% CI, 1.23-93.64) were independent predictors of poor outcome. The all-cause mortality rate was 31.2% (63/202) during the 3-4 yr after treatment initiation. In conclusion, the treatment outcomes of patients with MDR-TB at the 3 TB hospitals are poor, which may reflect the current status of MDR-TB in the public sector of Korea. A more comprehensive program against MDR-TB needs to be integrated into the National Tuberculosis Program of Korea.

Keywords: Extensively Drug-Resistant Tuberculosis; Mortality; Treatment Outcome; Tuberculosis, Multidrug-Resistant.

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Figures

Fig. 1

Baseline drug resistance among 202 patients with multidrug-resistant tuberculosis. INH, isoniazid; RFP, rifampicin; EMB, ethambutol; PZA, pyrazinamide; SM, streptomycin; KM, kanamycin; OFX, ofloxacin; PAS, _para_-aminosalicylic acid; PTH, prothionamide; CS, cycloserine.

Fig. 2

Kaplan-Meier estimates of survival for 202 patients with multidrug-resistant tuberculosis: (A) all-cause mortality according to previous treatment history (P = 0.032 for a vs b, P = < 0.001 for a vs c, P = 0.003 for b vs c, respectively) and (B) all-cause mortality between XDR-TB and non-XDR-TB (P = 0.002). XDR-TB, extensively drug-resistant tuberculosis.

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Treatment outcome and mortality among patients with multidrug-resistant tuberculosis in tuberculosis hospitals of the public sector - PubMed (original) (raw)