Dados do Trabalho

Título

Association between characteristics of drug-resistant tuberculosis and treatment outcomes in Paraná, Brazil

Introdução

In Brazil, a national plan aims to eradicate tuberculosis (TB) as a public health concern by reducing its incidence and mortality by 2035. One critical aspect of this strategy involves addressing the barriers to care for patients with drug-resistant tuberculosis (DR-TB). Understanding the demographic and health characteristics of these patients is vital due to the disease's association with treatment outcomes.  

Objetivo (s)

This study aims to identify the association between the sociodemographic and clinical-epidemiological characteristics of DR-TB cases and their treatment outcomes in Paraná, Brazil.

Material e Métodos

A descriptive study was conducted using notifications of DR-TB cases in Paraná state, Brazil, from 2019 to 2023. Data were sourced from the Tuberculosis Special Treatments Information System (SITE-TB). The variable "closure status" (treatment outcomes) was categorized into two groups: treatment success (cure and treatment completion) and treatment failure (primary abandonment, abandonment, TB-related death, and treatment failure). To determine the association between treatment outcomes and twelve other variables, either the chi-square test of independence or Fisher's exact test was applied, as appropriate.

Resultados e Conclusão

A total of 237 cases of DR-TB with fully completed notification forms were analyzed. There was a significant statistical association between treatment outcomes and four independent variables: number of previous treatments (p = 0.031), type of resistance (p = 0.035), initial resistance pattern (p = 0.003), and current resistance pattern (p = 0.003). The analysis revealed that a history of three previous treatments and primary resistance are positively associated with treatment success. Conversely, the initial and current patterns of monoresistance were found to increase the likelihood of treatment success, while acquired resistance, initial rifampicin resistance pattern, current multiresistance pattern, and rifampicin resistance were associated with lower probabilities of success. These findings can aid health authorities in defining priority strategies to reduce unfavorable outcomes from DR-TB treatment in the state. Furthermore, ensuring access to timely diagnostic tests and continuous training for health teams in the detection and management of DR-TB is crucial in Paraná.

Palavras Chave

Tuberculosis; multidrug-resistance; Epidemiology