Photo Credit: Denisfilm

The following is a summary of “Predictors of unsuccessful tuberculosis treatment outcomes in Brazil: an analysis of 259,484 patient records,” published in the May 2024 issue of Infectious Disease by Ryuk et al.

Due to the high death toll from tuberculosis (TB), effective treatment has become a critical weapon in the fight against the disease.

Researchers conducted a retrospective study in Brazil to identify factors linked to poor treatment outcomes for patients with TB.

They acquired data on patients with TB treated (2015 and 2018) from Brazil’s National Disease Notification System (SINAN). Patients with prior TB or diagnosed drug resistance were excluded. Information on patient factors, including demographics, comorbidities, behaviors, care levels, directly observed therapy (DOT) usage, and clinical results, was extracted. Treatment outcomes were classified as successful (cure, completion) or unsuccessful (death, regimen failure, loss to follow-up). Factors associated with unsuccessful treatment were identified using multivariate logistic regression models.

The results showed that of 259,484 individuals treated for drug-susceptible TB, 19.7% encountered an unsuccessful treatment outcome (7.8% died during treatment, 0.1% experienced regimen failure, and 11.9% were lost to follow-up). Older age (aOR 2.90 [95% CI: 2.62–3.21] for 85-100-year-olds vs. 25-34-year-olds), male sex (aOR 1.28 [1.25–1.32], vs. female sex), Black race (aOR 1.23 [1.19–1.28], vs. White race), no education (aOR 2.03 [1.91–2.17], vs. completing high school), HIV infection (aOR 2.72 [2.63–2.81], vs. no HIV infection), illicit drug use (aOR 1.95 [1.88–2.01], vs. no illicit drug use), alcohol consumption (aOR 1.46 [1.41–1.50], vs. abstaining from alcohol), smoking (aOR 1.20 [1.16–1.23], vs. non-smoking), homelessness (aOR 3.12 [2.95–3.31], vs. non-homelessness), and immigrant status (aOR 1.27 [1.11–1.45], vs. non-immigrants) were associated with higher odds of unsuccessful treatment. Treatment at tertiary care facilities (aOR 2.20 [2.14–2.27], vs. primary care) and lack of DOT (aOR 2.35 [2.29–2.41] vs. receiving DOT) were also linked to an increased likelihood of treatment failure.

Investigators found that tailored TB treatment in Brazil to individual and healthcare system factors could significantly improve treatment success rates.

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09417-7