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Factors associated with unsuccessful treatment of patients with drug-sensitive tuberculosis in Paraguay

dc.contributor.authorMontiel, Ivonne
dc.contributor.authorAlarcón, Edith
dc.contributor.authorAguirre, Sarita
dc.contributor.authorSequera, Guillermo
dc.contributor.authorMarín, Diana
dc.date.accessioned2020-08-10T21:28:15Z
dc.date.available2020-08-10T21:28:15Z
dc.date.issued2020-08
dc.identifier.citationMontiel I, Alarcón E, Aguirre S, Sequera G, Martín D. Factores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en Paraguay. Rev Panam Salud Publica. 2020;44:e89. https://doi.org/10.26633/RPSP.2020.89en_US
dc.identifier.issn1680 5348
dc.identifier.urihttps://iris.paho.org/handle/10665.2/52561
dc.description.abstract[RESUMEN]. Objetivo. Determinar los factores asociados con el tratamiento no exitoso en pacientes diagnosticados con tuberculosis (TB) sensible en Paraguay. Métodos. Estudio de cohorte retrospectivo, con datos recolectados del programa nacional entre enero de 2016 y marzo de 2017. Se definió tratamiento no exitoso como pacientes que se perdieron en el seguimiento, fracasaron en el tratamiento o fallecieron. Los factores asociados con tratamiento no exitoso se determinaron con regresión de Poisson; se estimó el riesgo relativo (RR) y el intervalo de confianza de 95% (IC95%) ajustados por región sanitaria. Resultados. Se estudiaron 3 034 casos: 2 189 (72,1%) tuvieron tratamiento exitoso (curados: 1 221 [40,2%], tratamiento completo: 968 [31,9%]) y 845 (27,9%) presentaron tratamiento no exitoso (fracaso: 40 [1,3%], pérdida de seguimiento: 466 [15,4%] y fallecidos: 339 [11,2%]). Los factores asociados a tratamiento no exitoso fueron hombres 1,28 (1,14- 1,42), indígenas 1,30 (1,09- 1,54), sin reporte de área de residencia 1,27 (1,02- 1,57), coinfección TB/VIH 1,97 (1,63- 2,38), adicción a drogas ilícitas 1,38 (1,16- 1,63), consumo de alcohol 1,25 (1,02- 1,52), ser previamente tratado 1,23 (1,10- 1,38) y sin datos de supervisión del tratamiento 4,92 (3,69- 6,56). Como factores protectores se consideran ser persona privada de libertad 0,65 (0,47- 0,89), así como la comorbilidad TB/diabetes 0,80 (0,67- 0,95). Conclusión. Paraguay presenta un alto porcentaje de tratamiento no exitoso en casi todo el país, sin alcanzar la meta propuesta por la Organización Mundial de la Salud. Los factores de riesgo asociados como infección por el virus de la inmunodeficiencia humana (VIH), consumo de drogas licitas e ilícitas y el ser indígena revela que es necesario revisar las estrategias dirigidas con abordaje interinstitucional.en_US
dc.description.abstract[ABSTRACT]. Objective. To determine the factors associated with the unsuccessful treatment of patients diagnosed with drug-sensitive tuberculosis (TB) in Paraguay. Methods. Retrospective cohort study, with data collected from the national program between January 2016 and March 2017. Unsuccessful treatment was defined as patients who were lost to follow-up, failed treatment, or died. Factors associated with unsuccessful treatment were determined using Poisson regression; the adjusted relative risk (RR) and 95% confidence interval (95% CI) were estimated by health region. Results. A total of 3 034 cases were studied: 2 189 (72.1%) were successfully treated (cured: 1 221 [40.2%], complete treatment: 968 [31.9%]) and 845 (27.9%) were unsuccessfully treated (treatment failure: 40 [1.3%], loss to follow-up: 466 [15.4%] and deaths: 339 [11.2%]). Factors associated with unsuccessful treatment were masculine sex 1.28 (1.14- 1.42), indigenous descent 1.3 (1.09- 1.54), lack of report of area of residence 1.27 (1.02- 1.57), TB/HIV coinfection 1.97 (1, 63- 2.38), illicit drug addiction 1.38 (1.16- 1.63), alcohol consumption 1.25 (1.02- 1.52), previous treatment 1.23 (1.10- 1.38) and lack of treatment monitoring data 4.92 (3.69- 6.56). Being deprived of liberty 0.65 (0.47- 0.89) and TB/diabetes comorbidity 0.80 (0.67- 0.95) were considered protective factors. Conclusion. Paraguay has a high percentage of unsuccessful treatment in almost the entire country, without reaching the target proposed by the World Health Organization. Associated risk factors such as HIV, consumption of legal and illicit drugs, and being indigenous highlight the need to revise the treatment strategies with an inter-institutional approach.en_US
dc.language.isoesen_US
dc.relation.ispartofseriesRev Panam Salud Publica;44, ago. 2020
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 IGO*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/igo/*
dc.subjectFactores de Riesgoen_US
dc.subjectTuberculosisen_US
dc.subjectVIHen_US
dc.subjectGrupos de Poblaciónen_US
dc.subjectParaguayen_US
dc.subjectRisk Factorsen_US
dc.subjectHIVen_US
dc.subjectPopulation Groupsen_US
dc.subjectOperations Researchen_US
dc.titleFactores asociados al resultado de tratamiento no exitoso de pacientes con tuberculosis sensible en Paraguayen_US
dc.titleFactors associated with unsuccessful treatment of patients with drug-sensitive tuberculosis in Paraguayen_US
dc.typeJournal articlesen_US
dc.rights.holderPan American Health Organizationen_US
paho.articletypeOriginal researchen_US
paho.isfeatured0en_US
dc.identifier.doihttps://doi.org/10.26633/RPSP.2020.89
paho.source.centercodeUS1.1en_US
dc.relation.ispartofjournalRevista Panamericana de Salud Públicaes_ES
dc.relation.ispartofjournalPan American Journal of Public Health


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