Volume 20, Number 3—March 2014
CME ACTIVITY - Research
Use of Drug-Susceptibility Testing for Management of Drug-Resistant Tuberculosis, Thailand, 2004–2008
Eugene Lam, Sriprapa Nateniyom, Sara Whitehead, Amornrat Anuwatnonthakate, Patama Monkongdee, Apiratee Kanphukiew, Jiraphan Inyaphong, Wanlaya Sitti, Navarat Chiengsorn, Saiyud Moolphate, Suporn Kavinum, Narin Suriyon, Pranom Limsomboon, Junya Danyutapolchai, Chalinthorn Sinthuwattanawibool, and Laura Jean Podewils
Table 5,
Appendix Association between sociodemographic, clinical, and treatment characteristics and poor treatment outcome among 194 RIF-resistant and MDR TB patients, Thailand 2004–2008*
| Characteristic | Poor outcome/total outcomes† | Analysis, odds ratio (95% CI) |
||||
|---|---|---|---|---|---|---|
| Univariate | p | Multivariate‡ | p | |||
| Age, y | ||||||
| <45 | 28/76 (36.8) | Reference | ||||
| >45 |
43/118 (36.4) |
0.98 (0.5–1.8) |
0.96 |
|||
| Sex | ||||||
| M | 47/126 (37.3) | Reference | ||||
| F |
24/68 (35.2) |
0.92 (0.5–1.7) |
0.78 |
|||
| Marital status | ||||||
| Married | 31/106 (29.3) | Reference | Reference | |||
| Single/divorced/widowed |
40/87 (46.0) |
2.1 (1.1–3.7) |
0.02 |
2.3 (1.2–4.6) |
0.01 |
|
| Nationality | ||||||
| Thai | 57/164 (34.8) | Reference | ||||
| Not Thai |
14/30 (46.7) |
1.6 (0.7–3.6) |
0.22 |
|||
| Case status | ||||||
| New | 38/111 (34.2) | Reference | ||||
| Retreatment | 27/64 (42.2) | 1.4 (0.7–2.6) | 0.30 | |||
| Transfer in/other |
6/19 (31.6) |
0.89 (0.3–2.5) |
0.82 |
|||
| Site of TB | ||||||
| Pulmonary | 65/179 (36.3) | Reference | ||||
| Extrapulmonary or both |
6/15 (40.0) |
1.2 (0.4–3.4) |
0.78 |
|||
| Cough >2 wk | ||||||
| No | 21/49 (42.9) | Reference | ||||
| Yes |
50/145 (34.5) |
0.70 (0.4–1.4) |
0.29 |
|||
| Smear status | ||||||
| Negative | 9/27 (33.3) | Reference | ||||
| Positive |
60/159 (37.7) |
1.2 (0.5–2.9) |
0.66 |
|||
| Cavitation seen on chest x-ray | ||||||
| No | 48/127 (37.8) | Reference | ||||
| Yes |
14/37 (37.8) |
1.0 (0.5–2.1) |
1.0 |
|||
| HIV status | ||||||
| Negative | 37/125 (29.6) | Reference | Reference | |||
| Positive |
28/57 (49.1) |
2.3 (1.2–4.4) |
0.01 |
2.2 (1.2–4.6) |
0.04 |
|
| Resistance pattern | ||||||
| RIF | 8/34 (23.5) | Reference | ||||
| MDR |
63/160 (39.4) |
2.1 (0.9–5.0) |
0.09 |
|||
| DOT | ||||||
| Health care worker | 21/65 (32.3) | Reference | ||||
| Family/other | 45/112 (40.2) | 1.4 (0.7–2.7) | 0.30 | |||
| None |
5/17 (29.4) |
0.87 (0.3–2.8) |
0.82 |
|||
| Category II treatment | ||||||
| None | 50/155 (32.3) | Reference | Reference | |||
| Pre-DST only | 15/26 (57.7) | 2.9 (1.2–6.7) | 0.02 | 2.5 (1.1–6.4) | 0.05 | |
| Post-DST/ full treatment course |
4/9 (44.4) |
1.7 (0.4–6.5) |
0.45 |
2.8 (0.7–11.6) |
0.16 |
|
| Delay from sputum collection to first post-DST visit, d | ||||||
| 35–74 | 10/33 (30.3) | Reference | ||||
| 75–112 | 5/31 (16.1) | 0.44 (0.1–1.5) | 0.19 | |||
| 113–155 | 8/36 (22.2) | 0.66 (0.2–1.9) | 0.44 | |||
| >155 | 7/32 (21.9) | 0.64 (0.2–2.0) | 0.44 | |||
*Patients were from the Thailand TB Active Surveillance Network and were restricted to those from the current study for whom final treatment outcomes were available (excluding transferred out, still receiving treatment). RIF, rifampin; MDR TB, multidrug-resistant tuberculosis; DOT, directly observed treatment; DST, drug-susceptibility testing.
†Poor treatment outcome included treatment failure, default, and death. Data are no. patients with poor outcome/no. patients total unless otherwise specified.
‡Adjusted for age as a continuous variable.
Page created: February 25, 2014
Page updated: February 25, 2014
Page reviewed: February 25, 2014
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