Título:
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Poor tuberculosis treatment outcomes in Southern Mozambique
(2011-2012)
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Autor/a:
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García-Basteiro, Alberto L.; Respeito, Durval; Augusto, Orvalho; López-Varela, Elisa; Sacoor, Charfudin; Sequera, Víctor Guillermo; Casellas, Aina; Bassat Orellana, Quique; Manhica, Ivan; Macete, Eusébio; Cobelens, Frank; Alonso, Pedro
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Abstract:
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BACKGROUND: In Mozambique, there is limited data regarding the
monitoring of Tuberculosis (TB) treatment results and
determinants of adverse outcomes under routine surveillance
conditions. The objectives of this study were to evaluate
treatment outcomes among TB patients, analyze factors associated
with a fatal outcome and determine the proportion of deaths
attributable to TB in the district of Manhica, Southern
Mozambique. METHODS: This is a retrospective observational study
based on TB patients diagnosed in the period 2011-2012. We used
three different data sources: a) TB related variables collected
by the National TB Control Program in the district of Manhica
for all TB cases starting treatment in the period 2011-2012. b)
Population estimates for the district were obtained through the
Mozambican National Statistics Institute. c) Deaths and other
relevant demographic variables were collected from the Health
and Demographic Surveillance System at Manhica Health Research
Center. WHO guidelines were used to define TB cases and
treatment outcomes. RESULTS: Of the 1957 cases starting TB
treatment in the period 2011-2012, 294 patients (15.1 %) died
during anti-tuberculous treatment. Ten per cent of patients
defaulted treatment. The proportion of patients considered to
have treatment failure was 1.1 %. HIV infection (OR 2.73; 95 %
CI: 1.70-4.38), being female (OR: 1.39; 95 % CI: 1.31-1.91) and
lack of laboratory confirmation (OR 1.51; 95 % CI: 1.10-2.08)
were associated with dying during the course of TB treatment (p
value <0.05). The contribution of TB to the overall death
burden of the district for natural reasons was 6.5 % (95 % CI:
5.5-7.6), higher for males than for females (7.8 %; 95 % CI:
6.1-9.5 versus 5.4 %; 95 % CI: 4.1-6.8 respectively). The age
group within which TB was responsible for the highest proportion
of deaths was 30-34 among males and 20-24 among females (20 % of
all deaths in both cases). CONCLUSION: This study shows a very
high proportion of fatal outcomes among TB cases starting
treatment. There is a high contribution of TB to the overall
causes of mortality. These results call for action in order to
improve TB (and TB/HIV) management and thus treatment outcomes
of TB patients. |
Materia(s):
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-Tuberculosi -Moçambic -Tuberculosis -Mozambique |
Derechos:
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cc by (c) García-Basteiro et al., 2016
http://creativecommons.org/licenses/by/3.0/es/ |
Tipo de documento:
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Artículo Artículo - Versión publicada |
Editor:
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BioMed Central
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