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Research article
Le Hong Van
The University of Manchester Faculty of Biology Medicine and Health
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3151-834X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcome. Predictors of poor outcomes vary in different health-care settings. Vietnam is among the 30 countries with high burden of MDR-TB. We aim to describe demographic characteristics and identify risk factors for poor outcome of MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam.
Methods
This retrospective study included 2,267 patients who initiated MDR-TB treatment from 2011 to 2015 in HCMC. Treatment outcomes were available in 2,241 patients. Data was collected from standardized paper-based treatment cards and electronic records. Statistical analysis was performed using R program.
Results
Among 2,267 eligible cases, 60.2% were failure of category I or II regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. Notification rate increased 24.7% from 2011 to 2015.Treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (odds ratio (OR): 2.92), advanced age (OR: 1.47 for every increase of 5 years for patients older than 60), having history of MDR-TB treatment (OR: 5.65), sputum smear grade scanty and 1+ (OR: 1.48), smear grade 2+ or 3+ (OR: 2.07), low BMI (OR: 0.84 for every increase of 1kg/m2 of BMI for patients with BMI<21).
Conclusion
Our study describes the increasing burden of MDR-TB in HCMC and the need for better drug resistance screening for all TB patients. Patients with HIV, high smear grade, malnutrition and history of previous MDR-TB treatment should receive additional care.
Keywords
multidrug resistant tuberculosis; retrospective; treatment outcome; risk factors; Vietnam
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
No community comments so far
Editorial decision: Accept
On 11 Feb, 2020
Editor assigned
On 10 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
No comments provided
Editorial decision: Minor revision
On 06 Feb, 2020
Review #1 received
Received 03 Feb, 2020
Reviewers invited
Invitations sent on 24 Jan, 2020
Reviewer #1 agreed
On 24 Jan, 2020
Editor assigned
On 18 Dec, 2019
Submission checks complete
On 17 Dec, 2019
Editor invited
On 17 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 04 Dec, 2019
Review #3 received
Received 02 Dec, 2019
Review #2 received
Received 01 Dec, 2019
Reviewer #3 agreed
On 23 Nov, 2019
Reviewer #2 agreed
On 21 Nov, 2019
Editor assigned
On 20 Nov, 2019
Reviewers invited
Invitations sent on 20 Nov, 2019
Reviewer #1 agreed
On 20 Nov, 2019
Review #1 received
Received 20 Nov, 2019
Submission checks complete
On 19 Nov, 2019
Editor invited
On 19 Nov, 2019
Version 1
Posted 28 Jul, 2019
No comments provided
Editorial decision: Major revision
On 15 Oct, 2019
Review #3 received
Received 14 Oct, 2019
Reviewer #3 agreed
On 09 Oct, 2019
Review #1 received
Received 23 Sep, 2019
Review #2 received
Received 21 Sep, 2019
Reviewer #2 agreed
On 08 Sep, 2019
Reviewer #1 agreed
On 07 Sep, 2019
Reviewers invited
Invitations sent on 04 Sep, 2019
Editor assigned
On 24 Jul, 2019
Submission checks complete
On 23 Jul, 2019
Editor invited
On 23 Jul, 2019
First submitted
On 17 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Le Hong Van
The University of Manchester Faculty of Biology Medicine and Health
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3151-834X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
No community comments so far
Editorial decision: Accept
On 11 Feb, 2020
Editor assigned
On 10 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
No comments provided
Editorial decision: Minor revision
On 06 Feb, 2020
Review #1 received
Received 03 Feb, 2020
Reviewers invited
Invitations sent on 24 Jan, 2020
Reviewer #1 agreed
On 24 Jan, 2020
Editor assigned
On 18 Dec, 2019
Submission checks complete
On 17 Dec, 2019
Editor invited
On 17 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 04 Dec, 2019
Review #3 received
Received 02 Dec, 2019
Review #2 received
Received 01 Dec, 2019
Reviewer #3 agreed
On 23 Nov, 2019
Reviewer #2 agreed
On 21 Nov, 2019
Editor assigned
On 20 Nov, 2019
Reviewers invited
Invitations sent on 20 Nov, 2019
Reviewer #1 agreed
On 20 Nov, 2019
Review #1 received
Received 20 Nov, 2019
Submission checks complete
On 19 Nov, 2019
Editor invited
On 19 Nov, 2019
Version 1
Posted 28 Jul, 2019
No comments provided
Editorial decision: Major revision
On 15 Oct, 2019
Review #3 received
Received 14 Oct, 2019
Reviewer #3 agreed
On 09 Oct, 2019
Review #1 received
Received 23 Sep, 2019
Review #2 received
Received 21 Sep, 2019
Reviewer #2 agreed
On 08 Sep, 2019
Reviewer #1 agreed
On 07 Sep, 2019
Reviewers invited
Invitations sent on 04 Sep, 2019
Editor assigned
On 24 Jul, 2019
Submission checks complete
On 23 Jul, 2019
Editor invited
On 23 Jul, 2019
First submitted
On 17 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
Background
Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcome. Predictors of poor outcomes vary in different health-care settings. Vietnam is among the 30 countries with high burden of MDR-TB. We aim to describe demographic characteristics and identify risk factors for poor outcome of MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam.
Methods
This retrospective study included 2,267 patients who initiated MDR-TB treatment from 2011 to 2015 in HCMC. Treatment outcomes were available in 2,241 patients. Data was collected from standardized paper-based treatment cards and electronic records. Statistical analysis was performed using R program.
Results
Among 2,267 eligible cases, 60.2% were failure of category I or II regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. Notification rate increased 24.7% from 2011 to 2015.Treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (odds ratio (OR): 2.92), advanced age (OR: 1.47 for every increase of 5 years for patients older than 60), having history of MDR-TB treatment (OR: 5.65), sputum smear grade scanty and 1+ (OR: 1.48), smear grade 2+ or 3+ (OR: 2.07), low BMI (OR: 0.84 for every increase of 1kg/m2 of BMI for patients with BMI<21).
Conclusion
Our study describes the increasing burden of MDR-TB in HCMC and the need for better drug resistance screening for all TB patients. Patients with HIV, high smear grade, malnutrition and history of previous MDR-TB treatment should receive additional care.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
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