Abstract

BERNABE ORTIZ, Antonio. Early detection in treatment failure in patients with pulmonary tuberculosis. Rev Med Hered [online]. 2007, vol.18, n.3, pp.123-128. ISSN 1018-130X.

Objective: To identify factors associated with therapy failure in patients with pulmonary tuberculosis during the first two months of specific treatment, based on weight, body mass index (BMI) and sputum. Materials and Methods: A retrospective case-control study matched by sex and age (± 2 years) was undertaken in Pampas de San Juan de Miraflores. All therapy failures between 2000 and June 2004 with smear-positive results were included as cases; while patients who had a positive sputum result at the treatment beginning and were declared as cured by the program criteria were controls, 2 per each case. Results: Twenty eight cases were matched with 56 controls. Factors associated with treatment failure included: at the therapy beginning, previous treatment history (OR = 3.54, 95% IC: 1.22-10.26). At the first treatment month, body mass index loss (OR = 10.65, 95% IC: 2.02-56.01); whilst at the second month of treatment, a smear-positive result (OR = 25.58, 95%IC: 2.10-311.27) and BMI loss (OR = 7.08, 95%IC: 1.06-47.55) were associated. Any control had a positive sputum result after third month of treatment. Conclusions: This study shows that some patients who will have therapy failure could be detected during treatment; especially by means of the previous treatment history, variation of BMI and smear-positive result at the second month. These findings could improve the multi-drug resistant tuberculosis (MDR-TB) diagnosis and prompt initiation of appropriate treatment.(Rev Med Hered 2007;18:123-128).

Keywords : Tuberculosis treatment failure; smear; body mass index; weight.

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