Isoniazid Monoresistance and Antituberculosis Treatment Outcome in Persons With Pulmonary Tuberculos...
Isoniazid Monoresistance and Antituberculosis Treatment Outcome in Persons With Pulmonary Tuberculosis in Brazil
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Author / Creator
Araújo-Pereira, Mariana , Arriaga, María B , Carvalho, Anna Cristina C , Spener-Gomes, Renata , Schmaltz, Carolina A S , Nogueira, Betânia M F , Figueiredo, Marina C , Turner, Megan M , Cordeiro-Santos, Marcelo , Rolla, Valeria C , Sterling, Timothy R , Andrade, Bruno B , Kritski, Afrânio L , for the Regional Prospective Observational Research for Tuberculosis (RePORT)-Brazil Consortium and Regional Prospective Observational Research for Tuberculosis (RePORT)-Brazil Consortium
Publisher
US: Oxford University Press
Journal title
Language
English
Formats
Publication information
Publisher
US: Oxford University Press
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More information
Scope and Contents
Contents
Abstract
Background
The high burden of drug-resistant tuberculosis (TB) is a problem to achieve the goals of the End TB Strategy by 2035. Whether isoniazid monoresistance (Hr) affects anti-TB treatment (ATT) outcomes remains unknown in high-burden countries.
Methods
We evaluated determinants of ATT outcome among pulmonary TB cases reported to the National Notifiable Disease Information System (SINAN) between June 2015 and June 2019, according to drug sensitivity testing (DST) results. Binomial logistic regression models were employed to evaluate whether Hr was associated with an unfavorable ATT outcome: death or failure, compared to cure or treatment completion.
Results
Among 60 804 TB cases reported in SINAN, 21 197 (34.9%) were included in the study. In this database, the frequency of unfavorable outcomes was significantly higher in those with Hr in contrast to isoniazid-sensitive persons with pulmonary TB (9.1% vs 3.05%; P < .001). Using a binomial logistic regression model, Hr was independently associated with unfavorable outcomes (odds ratio, 3.34 [95% confidence interval, 2.06–5.40]; P < .001).
Conclusions
Hr detected prior to ATT was predictive of unfavorable outcomes at the national level in Brazil. Our data reinforce the need for high-TB-burden countries to prioritize DST to detect Hr. Effective treatment regimens for Hr-TB are needed to improve outcomes.
Isoniazid monoresistance was associated with increased risk of unfavorable anti-tuberculosis (TB) treatment outcomes undertaking standard isoniazid, rifampin, pyrazinamide, and ethambutol regimen independent of age, sex, body mass index, HIV seropositivity, and glycemic status. This underscores the need for new treatment regimens to improve TB treatment outcomes.
Graphical Abstract
Graphical Abstract
This graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/isoniazid-monoresistance-and-anti-tuberculosis-treatment-outcome-in-persons-with-pulmonary-tuberculosis-in-brazil-36f503ef-d241-4583-adbe-e7c7a8ef4cec...
Alternative Titles
Full title
Isoniazid Monoresistance and Antituberculosis Treatment Outcome in Persons With Pulmonary Tuberculosis in Brazil
Authors, Artists and Contributors
Author / Creator
Arriaga, María B
Carvalho, Anna Cristina C
Spener-Gomes, Renata
Schmaltz, Carolina A S
Nogueira, Betânia M F
Figueiredo, Marina C
Turner, Megan M
Cordeiro-Santos, Marcelo
Rolla, Valeria C
Sterling, Timothy R
Andrade, Bruno B
Kritski, Afrânio L
for the Regional Prospective Observational Research for Tuberculosis (RePORT)-Brazil Consortium
Regional Prospective Observational Research for Tuberculosis (RePORT)-Brazil Consortium
Identifiers
Primary Identifiers
Record Identifier
TN_cdi_proquest_miscellaneous_2914258326
Permalink
https://devfeature-collection.sl.nsw.gov.au/record/TN_cdi_proquest_miscellaneous_2914258326
Other Identifiers
ISSN
2328-8957
E-ISSN
2328-8957
DOI
10.1093/ofid/ofad691
