Tuberculosis recurrences and predictive factors in a vulnerable population in Catalonia

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• dc.contributor.author Brugueras, Silvia
• dc.contributor.author Molina, Vinicio-Israel
• dc.contributor.author Casas, Xavier
• dc.contributor.author González, Yoel-Domingo
• dc.contributor.author Forcada, Núria
• dc.contributor.author Romero, Dora
• dc.contributor.author Rodés, Anna
• dc.contributor.author Altet, Maria-Neus
• dc.contributor.author Maldonado, José
• dc.contributor.author Martin-Sánchez, Mario
• dc.contributor.author Caylà i Busqueras, Joan A.
• dc.contributor.author Orcau, Àngels
• dc.contributor.author Rius, Cristina
• dc.contributor.author Millet, Joan-Pau
• dc.date.accessioned 2021-03-12T06:48:03Z
• dc.date.available 2021-03-12T06:48:03Z
• dc.date.issued 2020
• dc.description.abstract Background: Patients with a history of tuberculosis (TB) have a high probability of recurrence because long-term cure is not always maintained in successfully treated patients. The aim of this study was to identify the probability of TB recurrence and its predictive factors in a cohort of socially vulnerable patients who completed treatment in the TB referral center in Catalonia, which acts as the center for patients with social and health problems. Methods: This retrospective open cohort study included all patients diagnosed with TB who were admitted and successfully treated in Serveis Clínics between 2000 and 2016 and who remained disease-free for a minimum of 1 year after treatment completion. We calculated the incidence density of TB recurrences per person-years of follow-up. We also estimated the cumulative incidence of TB recurrence at 1, 2, 5, and 10 years of follow-up. Bivariate analysis was conducted using Kaplan-Meier curves. Multivariate analysis was conducted using Cox regression. Hazard ratios (HR) were calculated with their 95% confidence intervals (95%CI). Results: There were 839 patients and 24 recurrences (2.9%), representing 0.49 per 100 person-years. The probability of a recurrence was 0.63% at 1 year of follow-up, 1.35% at 2 years, and 3.69% at 5 years. The multivariate analysis showed that the predictive factors of recurrence were age older than 34 years (aHR = 3.90; CI = 1.06-14.34 at age 35-45 years and aHR = 3.88; CI = 1.02-14.80 at age >45 years) and resistance to at least one anti-TB drug (aHR = 2.91; CI = 1.11-7.65). Conclusions: Attention should be paid to socially vulnerable persons older than 34 years with a previous episode of resistant TB. Surveillance resources should be directed toward adequately treated patients who nevertheless have a high risk of recurrence.
• dc.format.mimetype application/pdf
• dc.identifier.citation Brugueras S, Molina VI, Casas X, González YD, Forcada N, Romero D, Rodés A, Altet MN, Maldonado J, Martin-Sánchez M, Caylà JA, Orcau À, Rius C, Millet JP. Tuberculosis recurrences and predictive factors in a vulnerable population in Catalonia. PLoS One. 2020; 15(1):e0227291. DOI: 10.1371/journal.pone.0227291
• dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0227291
• dc.identifier.issn 1932-6203
• dc.identifier.uri http://hdl.handle.net/10230/46734
• dc.language.iso eng
• dc.publisher Public Library of Science (PLoS)
• dc.relation.ispartof PLoS One. 2020; 15(1):e0227291
• dc.rights © 2020 Brugueras et al. This is an open access article distributed under the terms of the Creative Commons Attribution License https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri https://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Tuberculosis
• dc.subject.keyword Medical risk factors
• dc.subject.keyword Epidemiology
• dc.subject.keyword Extensively drug-resistant tuberculosis
• dc.subject.keyword Spain
• dc.subject.keyword HIV
• dc.subject.keyword Smoking habits
• dc.subject.keyword HIV infections
• dc.title Tuberculosis recurrences and predictive factors in a vulnerable population in Catalonia
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion