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Sociodemographic and Clinical Factors Associated with Treatment Outcomes for Drug-resistant Tuberculosis

Ana Carolina de Oliveira Jeronymo NevesMedical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;

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Ana Paula Gomes dos SantosMedical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;

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Regielle Luiza de MedeirosMedical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;

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Ana Júlia de Oliveira JeronymoFederal University of Juiz de Fora, Minas Gerais, Brazil;

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Guilherme Coelho NevesFederal University of Juiz de Fora, Minas Gerais, Brazil;

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Isabela Neves de AlmeidaFederal University of Ouro Preto, Minas Gerais, Brazil

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Fernanda Carvalho de Queiroz MelloMedical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;

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Afrânio Lineu KritskiMedical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;

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ABSTRACT.

Drug-resistant tuberculosis (DR-TB) continues to be a serious public health problem. The objective of this study was to evaluate the sociodemographic, radiological, clinical, and outcome characteristics and assess the determinants of unfavorable outcomes in DR-TB. The descriptive-analytical study was carried out in a reference outpatient clinic in Rio de Janeiro, Brazil, among DR-TB cases that received treatment between February 2016 and October 2020, using descriptive statistics, χ2 test, and logistic regression multivariate. Of the 148 cases, 12.2% were resistant to rifampicin, 12.2% were resistant to isoniazid, 18.2% were polyresistant, 56.1% multidrug resistant, and 1.3% were extensively drug resistant. Most of the patients were men, aged up to 44 years, with brown or black skin, having up to 8 years of schooling, unemployed or working in the informal economy, and of low income. Presenting with acquired resistance or positive sputum smear microscopy in the diagnosis, taking more than four drugs, and being unemployed were associated with unfavorable outcomes. Having no income or acquired resistance doubled the chances of unfavorable outcomes. There was a high proportion of unfavorable outcomes, thereby highlighting the need to concentrate efforts on planning and executing public policies that include the severity of DR-TB and its risk factors.

Author Notes

Address correspondence to Ana Carolina de Oliveira Jeronymo Neves, Rua Prof. Rodolpho Paulo Rocco, 255—University City of the Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21941-913, Brazil. E-mail: anacarol.jeronymo@gmail.com

Authors’ addresses: Ana Carolina de Oliveira Jeronymo Neves, Ana Paula Gomes dos Santos, Regielle Luiza de Medeiros, Fernanda Carvalho de Queiroz Mello, and Afrânio Lineu Kritski, Medical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, E-mails: anacarol.jeronymo@gmail.com, anapsantos.ip@gmail.com, regielle.luiza@gmail.com, fcqmello@gmail.com, and kritskia@gmail.com. Ana Júlia de Oliveira Jeronymo and Guilherme Coelho Neves, Federal University of Juiz de Fora, Minas Gerais, Brazil, E-mails: anaju.jeronymo@gmail.com and guilhermecoelhoneves@gmail.com. Isabela Neves de Almeida, Federal University of Ouro Preto, Minas Gerais, Brazil, E-mail: isabelanalmeida@gmail.com.

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