Clinical risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Mali.
Mali
Multi-Drug Resistant Tuberculosis
Risk factors
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
04
01
2019
revised:
04
02
2019
accepted:
08
02
2019
pubmed:
18
2
2019
medline:
14
6
2019
entrez:
18
2
2019
Statut:
ppublish
Résumé
MDR-TB is a major threat to global TB control. In 2015, 580,000 were treated for MDR-TB worldwide. The worldwide roll-out of GeneXpert MTB/RIF We performed a cross-sectional study of 214 patients with presumed MDR-TB admitted to University of Bamako Teaching Hospital, Point-G between 2007 and 2016. We calculated crude and adjusted odds ratios for MDR-TB disease diagnosis using SPSS. We found that age ≤40years (OR=2.56. 95% CI: 1.44-4.55), two courses of prior TB treatment (OR=3.25, 95% CI: 1.44-7.30), TB treatment failure (OR=3.82, 95% CI 1.82-7.79), sputum microscopy with 3+ bacilli load (OR=1.98, 95% CI: 1.13-3.48) and a history of contact with a TB patient (OR=2.48, 95% CI: 1.11-5.50) were significantly associated with confirmation of MDR-TB disease. HIV was not a risk factor for MDR-TB (aOR=0.88, 95% CI: 0.34-1.94). We identified several risk factors that could be used to identify MDR-TB suspects and prioritize them for laboratory confirmation. Prospective studies are needed to understand factors associated with TB incidence and clinical outcomes of TB treatment and disease.
Sections du résumé
BACKGROUND
BACKGROUND
MDR-TB is a major threat to global TB control. In 2015, 580,000 were treated for MDR-TB worldwide. The worldwide roll-out of GeneXpert MTB/RIF
METHODS
METHODS
We performed a cross-sectional study of 214 patients with presumed MDR-TB admitted to University of Bamako Teaching Hospital, Point-G between 2007 and 2016. We calculated crude and adjusted odds ratios for MDR-TB disease diagnosis using SPSS.
RESULTS
RESULTS
We found that age ≤40years (OR=2.56. 95% CI: 1.44-4.55), two courses of prior TB treatment (OR=3.25, 95% CI: 1.44-7.30), TB treatment failure (OR=3.82, 95% CI 1.82-7.79), sputum microscopy with 3+ bacilli load (OR=1.98, 95% CI: 1.13-3.48) and a history of contact with a TB patient (OR=2.48, 95% CI: 1.11-5.50) were significantly associated with confirmation of MDR-TB disease. HIV was not a risk factor for MDR-TB (aOR=0.88, 95% CI: 0.34-1.94).
CONCLUSION
CONCLUSIONS
We identified several risk factors that could be used to identify MDR-TB suspects and prioritize them for laboratory confirmation. Prospective studies are needed to understand factors associated with TB incidence and clinical outcomes of TB treatment and disease.
Identifiants
pubmed: 30772470
pii: S1201-9712(19)30068-2
doi: 10.1016/j.ijid.2019.02.004
pmc: PMC6481646
mid: NIHMS1526691
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
149-155Subventions
Organisme : FIC NIH HHS
ID : D43 TW010350
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI110386
Pays : United States
Organisme : NIAID NIH HHS
ID : R03 AI137674
Pays : United States
Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.
Références
Thorax. 2006 Feb;61(2):158-63
pubmed: 16254056
J Infect Dis. 2007 Aug 15;196 Suppl 1:S86-107
pubmed: 17624830
Microb Drug Resist. 2009 Sep;15(3):217-21
pubmed: 19728781
PLoS One. 2012;7(5):e36902
pubmed: 22615839
Bangladesh Med Res Counc Bull. 2013 Apr;39(1):34-41
pubmed: 23923410
PLoS One. 2013 Aug 01;8(8):e70763
pubmed: 23936467
PLoS One. 2014 Jan 08;9(1):e82235
pubmed: 24416139
Indian J Med Microbiol. 2014 Jul-Sep;32(3):270-6
pubmed: 25008819
Afr Health Sci. 2015 Jun;15(2):368-77
pubmed: 26124781
Int J Infect Dis. 2015 Oct;39:57-61
pubmed: 26327121
PLoS One. 2015 Oct 07;10(10):e0139986
pubmed: 26444421
BMC Infect Dis. 2015 Oct 26;15:461
pubmed: 26503269
Int J Mycobacteriol. 2012 Sep;1(3):137-42
pubmed: 26787209
BMC Pulm Med. 2016 Feb 04;16:26
pubmed: 26846562
Int J Tuberc Lung Dis. 2016 Jun;20(6):793-9
pubmed: 27155183
Ann Transl Med. 2016 May;4(9):168
pubmed: 27275481
Malays J Med Sci. 2016 Jul;23(4):17-25
pubmed: 27660541
PLoS One. 2016 Nov 28;11(11):e0166807
pubmed: 27893795
BMC Infect Dis. 2016 Nov 28;16(1):714
pubmed: 27894266
PLoS One. 2017 Jan 12;12(1):e0169798
pubmed: 28081227
Int J Infect Dis. 2017 Mar;56:14-20
pubmed: 28163165
Infect Drug Resist. 2017 Mar 13;10:91-96
pubmed: 28331350
Pan Afr Med J. 2016 Nov 26;25(Suppl 2):5
pubmed: 28439330