Document Detail


Bodyweight gain to predict treatment outcome in patients with pulmonary tuberculosis in Peru.
MedLine Citation:
PMID:  18812045     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
SETTING: Tuberculosis control programmes of two health care centres in the central rainforest of Peru. OBJECTIVE: To evaluate if bodyweight gain (BWG) predicts treatment outcome in patients with pulmonary tuberculosis (PTB). DESIGN: Retrospective cohort study of adults with PTB diagnosed between 1995 and 2004. BWG was assessed after month 1 of treatment, after the initial phase and at the end of treatment. Patients were stratified into two BWG categories, < or = 5% and >5%. Failures and relapses were grouped together as unsuccessful treatment outcome. RESULTS: A total of 650 patients were included: 7.2% (n = 47) had an unsuccessful outcome. Unsuccessful outcome was associated with BWG < or = 5% at the end of treatment (RR 2.05, 95%CI 1.10-3.80), but not at the completion of month 1 (RR 0.99, 95%CI 0.52-1.88) or at completion of the initial phase (RR 1.46, 95%CI 0.82-2.57). Median BWG at completion of the initial phase was higher in cured patients (P = 0.007). BWG < or = 5% at end of treatment (RR 2.35, 95%CI 1.17-4.72), initial sputum smear 2+ (RR 2.48, 95%CI 1.14-5.31) and positive smear microscopy at month 2 (RR 4.0, 95%CI 1.30-12.31) were independent predictors of unsuccessful treatment outcome. CONCLUSION: BWG < or = 5% at the end of treatment, high bacterial load and lack of sputum conversion correlate with unsuccessful treatment outcome in this setting. New discriminative cut-offs for BWG are proposed.
Authors:
F Krapp; J C Véliz; E Cornejo; E Gotuzzo; C Seas
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease     Volume:  12     ISSN:  1027-3719     ISO Abbreviation:  Int. J. Tuberc. Lung Dis.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-24     Completed Date:  2009-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706389     Medline TA:  Int J Tuberc Lung Dis     Country:  France    
Other Details:
Languages:  eng     Pagination:  1153-9     Citation Subset:  IM    
Affiliation:
Instituto de Medicina Tropical 'Alexander von Humboldt', Lima, Peru.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antitubercular Agents / therapeutic use*
Chi-Square Distribution
Female
Humans
Male
Peru / epidemiology
Predictive Value of Tests
ROC Curve
Retrospective Studies
Statistics, Nonparametric
Treatment Outcome
Tuberculosis, Pulmonary / drug therapy*,  epidemiology
Weight Gain*
Chemical
Reg. No./Substance:
0/Antitubercular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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