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Volume 16, Number 10—October 2010

Research

Therapeutic Drug Monitoring for Slow Response to Tuberculosis Treatment in a State Control Program, Virginia, USA

Scott K. HeysellComments to Author , Jane L. Moore, Suzanne J. Keller, and Eric R. Houpt
Author affiliations: Author affiliations: University of Virginia, Charlottesville, Virginia, USA (S.K. Heysell, E.R. Houpt); Virginia Department of Health, Richmond, Virginia, USA (J.L. Moore, S.J. Keller)

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Table 1

Baseline characteristics of adults treated for drug-susceptible pulmonary TB in a state control program, Virginia, USA, March 1, 2007–May 1, 2009*

Characteristic All patients, N = 311, no. (%) Slow response,
n = 42, no. (%) Normal response,
n = 269, no. (%) Bivariate OR (95% CI);
p value
Age, y
18–39 151 (49) 16 (38) 135 (50) Referent
40–64 90 (29) 13 (31) 77 (29) 1.4 (0.65–3.10); p = 0.38
>65
70 (22)
13 (31)
57 (21)
1.9 (0.87–4.30); p = 0.11
Sex
M 204 (65) 29 (69) 175 (65) Referent
F
107 (35)
13 (31)
94 (35)
0.84 (0.42–1.70); p = 0.61
Race/ethnicity
Asian 102 (33) 19 (45) 83 (31) Referent
Hispanic 82 (26) 11 (26) 71 (26) 0.67 (0.30–1.50); p = 0.34
Black 86 (28) 8 (19) 78 (29) 0.45 (0.19–1.10); p = 0.07
White 41 (13) 4 (10) 37 (14) 0.47 (0.15–1.50); p = 0.20
Native American
0
0
0

Foreign born
No 83 (27) 9 (21) 74 (28) Referent
Yes
228 (73)
33 (79)
195 (72)
1.4 (0.64–3.00); p = 0.41
Homeless
No 301 (97) 41 (98) 260 (97) Referent
Yes
10 (3)
1 (2)
9 (3)
0.71 (0.09–5.70); p = 0.74
Illicit drug use
No 298 (96) 42 (100) 256 (95) Referent
Non-injection use 7 (2) 0 7 (3) p>0.99
Injection use
6 (2)
0
6 (2)
p>0.99
Alcohol abuse
No 276 (89) 38 (91) 238 (89) Referent
Yes
35 (11)
4 (9)
31 (11)
0.81 (0.27–2.40); p = 0.70
HIV status
Negative 266 (86) 37 (88) 229 (85) Referent
Positive 11 (3) 0 11 (4) p>0.99
Unknown
34 (11)
5 (12)
29 (11)
1.1 (0.39–2.90); p = 0.90
Diabetes
No 270 (87) 25 (60) 245 (91) Referent
Yes
41 (13)
17 (40)
24 (9)
6.9 (3.3–14.6); p<0.001†
Prior TB history
No 291 (93) 38 (91) 253 (94) Referent
Yes 18 (6) 3 (7) 15 (5) 1.3 (0.37–4.80); p = 0.66
Unknown
2 (1)
1 (2)
1 (1)
6.6 (0.41–108.70); p = 0.18
Tuberculin skin test result
Negative 47 (15) 5 (12) 42 (16) Referent
Positive 179 (58) 23 (55) 156 (58) 1.2 (0.44–3.50); p = 0.68
Unavailable
85 (27)
14 (33)
71 (26)
1.7 (0.56–4.90); p = 0.36
Sputum smear
Negative 94 (30) 9 (21) 85 (31) Referent
Positive 193 (62) 30 (72) 163 (61) 1.7 (0.79–3.80); p = 0.17
Not done
24 (8)
3 (7)
21 (8)
1.3 (0.34–5.40); p = 0.67
Chest radiograph
No TB findings 16 (5) 2 (5) 14 (5) Referent
Noncavitary 173 (56) 19 (45) 154 (57) 0.86 (0.18–4.10); p = 0.85
Cavitary
122 (39)
21 (50)
101 (38)
1.5 (0.31–6.80); p = 0.64
Disease site
Pulmonary 212 (68) 32 (76) 180 (67) Referent
Pulmonary/extrapulmonary 99 (32) 10 (24) 89 (33) 0.63 (0.30–1.30); p = 0.23

*Tuberculin skin test values recorded in surveillance database as positive based on guidelines from the American Thoracic Society and Centers for Disease Control and Prevention (15). TB, tuberculosis; OR, odds ratio; CI, confidence interval.
†Adjusted odds ratio 6.3 (95% CI 2.8–14.0); p<0.001.

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