TY - JOUR
T1 - Tuberculosis diagnosed in a rural setting in angola. accuracy of follow-up sputum smears to predict outcome
AU - López, Teresa
AU - Moreno, Milagros
AU - Salvador, Fernando
AU - Zacarías, Adriano
AU - de Carvalho, Rosa
AU - Tomás, Estevao
AU - Estevao, Gabriel
AU - Eugenio, Arlette Nindia
AU - Burgos, Joaquin
AU - Sulleiro, Elena
AU - Molina, Israel
AU - Falcó, Vicenç
PY - 2013/1/1
Y1 - 2013/1/1
N2 - Objective: To analyze treatment outcome and the accuracy of positive sputum smear at 2 months to predict treatment failure in a cohort of patients with tuberculosis (TB) in a rural setting in Angola. Design: Observational study of patients with TB from January 2009 to August 2010 in Hospital Nossa Senhora da Paz in Angola. A multivariate analysis was performed to identify variables associated with treatment failure and death. Sensitivity, specificity, positive and negative predictive values and likelihood ratios to define the accuracy of a positive sputum smear at 2 months to predict treatment failure were calculated. Results: One thousand four hundred and twenty-five patients were diagnosed with TB. Overall, 526 patients were cured from TB and 419 had treatment completed, so 945 (66.3%) patients achieved treatment success. The outcomes of the remaining patients were: 91 (6.4%) had treatment failure, 100 (7%) died, 49 (3.4%) interrupted treatment, and 240 (16.8%) were transferred out. Variables associated with a higher risk of treatment failure were previously treated patients (odds ratio, 2.36; 95% confidence interval, 1.32-4.2) and positive sputum smear at 2 months (odds ratio, 9.81; 95% confidence interval, 5.88-16.36). Among the group of 551 patients with sputum smear confirmed at diagnosis and specimens taken at 2 and 5 months, the positive predictive value (31%) and the positive likelihood ratio (3.21) of a positive sputum smear taken at 2 months to predict treatment failure were low. Conclusions: Patients with positive sputum smear at 2 months have a higher risk of treatment failure. However, this by itself is a poor predictor of treatment failure. © W. S. Maney & Son Ltd 2013.
AB - Objective: To analyze treatment outcome and the accuracy of positive sputum smear at 2 months to predict treatment failure in a cohort of patients with tuberculosis (TB) in a rural setting in Angola. Design: Observational study of patients with TB from January 2009 to August 2010 in Hospital Nossa Senhora da Paz in Angola. A multivariate analysis was performed to identify variables associated with treatment failure and death. Sensitivity, specificity, positive and negative predictive values and likelihood ratios to define the accuracy of a positive sputum smear at 2 months to predict treatment failure were calculated. Results: One thousand four hundred and twenty-five patients were diagnosed with TB. Overall, 526 patients were cured from TB and 419 had treatment completed, so 945 (66.3%) patients achieved treatment success. The outcomes of the remaining patients were: 91 (6.4%) had treatment failure, 100 (7%) died, 49 (3.4%) interrupted treatment, and 240 (16.8%) were transferred out. Variables associated with a higher risk of treatment failure were previously treated patients (odds ratio, 2.36; 95% confidence interval, 1.32-4.2) and positive sputum smear at 2 months (odds ratio, 9.81; 95% confidence interval, 5.88-16.36). Among the group of 551 patients with sputum smear confirmed at diagnosis and specimens taken at 2 and 5 months, the positive predictive value (31%) and the positive likelihood ratio (3.21) of a positive sputum smear taken at 2 months to predict treatment failure were low. Conclusions: Patients with positive sputum smear at 2 months have a higher risk of treatment failure. However, this by itself is a poor predictor of treatment failure. © W. S. Maney & Son Ltd 2013.
KW - Multidrug resistant tuberculosis
KW - Predictors of treatment failure
KW - Tuberculosis
KW - Tuberculosis in resource limited settings
U2 - 10.1179/2047773212Y.0000000066
DO - 10.1179/2047773212Y.0000000066
M3 - Article
VL - 107
SP - 5
EP - 10
JO - Pathogens and Global Health
JF - Pathogens and Global Health
SN - 2047-7724
IS - 1
ER -