World Health Organization , 2021. Global Tuberculosis Report 2021. Geneva, Switzerland: WHO. Available at: https://www.who.int/publications/i/item/9789240037021. Accessed January 16, 2022.
Karo B et al., 2019. Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014. Euro Surveill 24: 1–13.
Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasil , 2021. Boletim Epidemiológico de Tuberculose. Brasília, Brasil: Ministério da Saúde. Available at: https://www.gov.br/saude/pt-br/media/pdf/2021/marco/24/boletim-tuberculose-2021_24.03. Accessed November 8, 2021.
Bhering M , Duarte R , Kritski A , 2019. Predictive factors for unfavourable treatment in MDR-TB and XDR-TB patients in Rio de Janeiro State, Brazil, 2000–2016. PLoS One 14: 1–14.
Bartholomay P , Pinheiro RS , Pelissari DM , Arakaki-Sanchez D , Dockhorn F , Rocha JL , Penna EQAA , Barreira D , Araújo WNA , Dalcomo M , 2019. Special Tuberculosis Treatment Information System (SITE-TB) in Brazil: background, description and perspectives. Epidemiol Serv Saude 28: 1–12.
Brasil, Ministério da Saúde , 1990. Lei n° 8.080, de 19 de setembro de 1990. Lei Orgânica da Saúde. Dispõe sobre as condições para a promoção, proteção e recuperação da saúde, a organização e o funcionamento dos serviços correspondentes e dá outras providências. Diário Oficial da União. 20 set 1990. Brasília, Brasil: Ministério da Saúde. Available at: http://www.planalto.gov.br/ccivil_03/leis/l8080.htm. Accessed November 20, 2021.
Brasil, Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância Epidemiológica , 2019. Manual de recomendações para o controle da tuberculose no Brasil. Brasília, Brasil: Ministério da Saúde. Available at: https://bvsms.saude.gov.br/bvs/publicacoes/manual_recomendacoes_controle_tuberculose_brasil_2_ed.pdf. Accessed November 8, 2021.
World Health Organization , 2014. Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-resistant Tuberculosis. Geneva, Switzerland: WHO. Available at: https://apps.who.int/iris/bitstream/handle/10665/130918/9789241548809_eng.pdf. Accessed January 14, 2022.
Lu Z et al., 2019. Drug resistance and epidemiology characteristics of multidrug-resistant tuberculosis patients in 17 provinces of China. PLoS One 14: 1–14.
Guidoni LM , Negri LSA , Carlesso GF , Zandonade E , Maciel ELN , 2021. Catastrophic costs in tuberculosis patients in Brazil: a study in five capitals. Esc Anna Nery 25: 1–8.
Moreira ASR , Kritski AL , Carvalho ACC , 2020. Social determinants of health and catastrophic costs associated with the diagnosis and treatment of tuberculosis. J Bras Pneumol 46: 1–5.
Bhering M , Dalcomo M , Sarubbi Júnior V , Kritski A , 2022. Barriers faced by patients in the diagnosis of multidrug-resistant tuberculosis in Brazil. Rev Saude Publica 56: 1–11.
Rudgard WE et al., 2018. Uptake of governmental social protection and financial hardship during drug-resistant tuberculosis treatment in Rio de Janeiro, Brazil. Eur Respir J 51: 1–5.
Bastos ML et al., 2017. Treatment outcomes of MDR-tuberculosis patients in Brazil: a retrospective cohort analysis. BMC Infect Dis 17: 1–12.
Van LH et al., 2020. Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study. BMC Infect Dis 20: 1–10.
Bhering M , Kritski A , 2020. Primary and acquired multidrug-resistant tuberculosis: Predictive factors for unfavorable treatment outcomes in Rio de Janeiro, 2000–2016. Rev Panam Salud Publica 30: 1–10.
Savioli MTG , Morrone N , Santoro I , 2019. Primary bacillary resistance in multidrugresistant tuberculosis and predictive factors associated with cure at a referral center in São Paulo, Brazil. J Bras Pneumol 45: 1–7.
Günther G et al., 2015. Multidrug-resistant tuberculosis in Europe, 2010–2011. Emerg Infect Dis 21: 409–416.
Soares VM , Almeida IN , Figueiredo LJA , Haddad JPA , Oliveira CSF , Carvalho WS , Miranda SS , 2020. Factors associated with tuberculosis and multidrug-resistant tuberculosis in patients treated at a tertiary referral hospital in the state of Minas Gerais, Brazil. J Bras Pneumol 46: 1–8.
Jacobs MG , Pinto VL Jr. , 2019. Characterization of drug-resistant tuberculosis in Brazil, 2014. Epidemiol Serv Saude 28: 1–9.
Matambo R et al., 2020. Treatment outcomes of multi drug resistant and rifampicin resistant Tuberculosis in Zimbabwe: a cohort analysis of patients initiated on treatment during 2010 to 2015. PLoS One 15: 1–15.
Zhang Y , Wu S , Xia Y , Wang N , Zhou L , Wang J , Fang R , Sun F , Chen M , Zhan S , 2017. Adverse events associated with treatment of multidrug-resistant tuberculosis in china: an ambispective cohort study. Med Sci Monit 23: 2348–2356.
Aibana O , Bachmaha M , Krasiuk V , Rybak N , Flanigan TP , Petrenko V , Murray MB , 2017. Risk factors for poor multidrug-resistant tuberculosis treatment outcomes in Kyiv Oblast, Ukraine. BMC Infect Dis 17: 1–7.
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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.
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: email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, and email@example.com. Ana Júlia de Oliveira Jeronymo and Guilherme Coelho Neves, Federal University of Juiz de Fora, Minas Gerais, Brazil, E-mails: firstname.lastname@example.org and email@example.com. Isabela Neves de Almeida, Federal University of Ouro Preto, Minas Gerais, Brazil, E-mail: firstname.lastname@example.org.