Tuberculosis diagnosed in a rural setting in angola. accuracy of follow-up sputum smears to predict outcome

Teresa López, Milagros Moreno, Fernando Salvador, Adriano Zacarías, Rosa de Carvalho, Estevao Tomás, Gabriel Estevao, Arlette Nindia Eugenio, Joaquin Burgos, Elena Sulleiro, Israel Molina, Vicenç Falcó

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6 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)5-10
JournalPathogens and Global Health
Volume107
Issue number1
DOIs
Publication statusPublished - 1 Jan 2013

Keywords

  • Multidrug resistant tuberculosis
  • Predictors of treatment failure
  • Tuberculosis
  • Tuberculosis in resource limited settings

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