PMID- 32087682 OWN - NLM STAT- MEDLINE DCOM- 20200505 LR - 20240329 IS - 1471-2334 (Electronic) IS - 1471-2334 (Linking) VI - 20 IP - 1 DP - 2020 Feb 22 TI - Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study. PG - 164 LID - 10.1186/s12879-020-4887-1 [doi] LID - 164 AB - BACKGROUND: Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcomes. Predictors of poor outcomes vary in different regions. Vietnam is among the top 30 high burden of MDR-TB countries. We describe demographic characteristics and identify risk factors for poor outcome among patients with MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam. METHODS: This retrospective study included 2266 patients who initiated MDR-TB treatment between 2011 and 2015 in HCMC. Treatment outcomes were available for 2240 patients. Data was collected from standardized paper-based treatment cards and electronic records. A Kruskal Wallis test was used to assess changes in median age and body mass index (BMI) over time, and a Wilcoxon test was used to compare the median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression with multiple imputation for missing data was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program. RESULTS: Among 2266 eligible cases, 60.2% had failed on a category I or II treatment regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. The notification rate increased 24.7% from 2011 to 2015. The treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty or 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1 kg/m2 of BMI for patients with BMI < 21). CONCLUSION: The number of patients diagnosed with MDR-TB in HCMC increased by almost a quarter between 2011 and 2015. Patients with HIV, high smear grade, malnutrition or a history of previous MDR-TB treatment are at greatest risk of poor treatment outcome. FAU - Van, Le Hong AU - Van LH AUID- ORCID: 0000-0003-3151-834X AD - Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam. vanlh@oucru.org. FAU - Phu, Phan Trieu AU - Phu PT AD - Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam. FAU - Vinh, Dao Nguyen AU - Vinh DN AD - Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam. FAU - Son, Vo Thanh AU - Son VT AD - Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam. FAU - Hanh, Nguyen Thi AU - Hanh NT AD - Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam. FAU - Nhat, Le Thanh Hoang AU - Nhat LTH AD - Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam. FAU - Lan, Nguyen Huu AU - Lan NH AD - Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam. FAU - Vinh, Truong Van AU - Vinh TV AD - Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam. FAU - Trang, Nguyen Thi Mai AU - Trang NTM AD - Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam. FAU - Ha, Dang Thi Minh AU - Ha DTM AD - Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam. FAU - Thwaites, Guy E AU - Thwaites GE AD - Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam. AD - Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK. FAU - Thuong, Nguyen Thuy Thuong AU - Thuong NTT AD - Tuberculosis group, Oxford University Clinical Research Unit, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Vietnam. thuongntt@oucru.org. LA - eng GR - WT_/Wellcome Trust/United Kingdom GR - 206724/Z/17/Z/WT_/Wellcome Trust/United Kingdom GR - 106680/B/14/Z/WT_/Wellcome Trust/United Kingdom PT - Journal Article DEP - 20200222 PL - England TA - BMC Infect Dis JT - BMC infectious diseases JID - 100968551 SB - IM MH - AIDS-Related Opportunistic Infections/*drug therapy/*epidemiology MH - Adult MH - Age Factors MH - Coinfection MH - Drug Resistance, Multiple, Bacterial/drug effects MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Male MH - Microbial Sensitivity Tests MH - Middle Aged MH - Mycobacterium tuberculosis/*genetics/isolation & purification MH - Retrospective Studies MH - Risk Factors MH - Sputum/microbiology MH - Treatment Outcome MH - Tuberculosis, Multidrug-Resistant/*drug therapy/*epidemiology MH - Vietnam/epidemiology PMC - PMC7036193 OTO - NOTNLM OT - Multidrug resistant tuberculosis OT - Retrospective OT - Risk factors OT - Treatment outcome OT - Vietnam COIS- All authors declare no competing interests. EDAT- 2020/02/24 06:00 MHDA- 2020/05/06 06:00 PMCR- 2020/02/22 CRDT- 2020/02/24 06:00 PHST- 2019/07/17 00:00 [received] PHST- 2020/02/13 00:00 [accepted] PHST- 2020/02/24 06:00 [entrez] PHST- 2020/02/24 06:00 [pubmed] PHST- 2020/05/06 06:00 [medline] PHST- 2020/02/22 00:00 [pmc-release] AID - 10.1186/s12879-020-4887-1 [pii] AID - 4887 [pii] AID - 10.1186/s12879-020-4887-1 [doi] PST - epublish SO - BMC Infect Dis. 2020 Feb 22;20(1):164. doi: 10.1186/s12879-020-4887-1.