Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis


Autoři: Ninfa Marlen Chaves Torres aff001;  Jecxy Julieth Quijano Rodríguez aff002;  Pablo Sebastián Porras Andrade aff003;  María Belen Arriaga aff004;  Eduardo Martins Netto aff001
Působiště autorů: Department of Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil aff001;  Department of Medicine, Nueva Granada Military University, Bogotá, D.C., Colombia aff002;  Department of Biology, The University of Queensland, Brisbane, Australia aff003;  Gonzalo Moniz Institute, Gonzalo Cruz Foundation, Salvador, Bahia, Brazil aff004;  Department of Epidemiology, José Silveira Foundation, Salvador, Bahia, Brazil aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226507

Souhrn

Objective

To produce pooled estimates of the global results of tuberculosis (TB) treatment and analyze the predictive factors of successful TB treatment.

Methods

Studies published between 2014 and 2019 that reported the results of the treatment of pulmonary TB and the factors that influenced these results. The quality of the studies was evaluated according to the Newcastle-Ottawa quality assessment scale. A random effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (CI). This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) in February 2019 under number CRD42019121512.

Results

A total of 151 studies met the criteria for inclusion in this review. The success rate for the treatment of drug-sensitive TB in adults was 80.1% (95% CI: 78.4–81.7). America had the lowest treatment success rate, 75.9% (95% CI: 73.8–77.9), and Oceania had the highest, 83.9% (95% CI: 75.2–91.0). In children, the success rate was 84.8% (95% CI: 77.7–90.7); in patients coinfected with HIV, it was 71.0% (95% CI: 63.7–77.8), in patients with multidrug-resistant TB, it was 58.4% (95% CI: 51.4–64.6), in patients with and extensively drug-resistant TB it was 27.1% (12.7–44.5). Patients with negative sputum smears two months after treatment were almost three times more likely to be successfully treated (OR 2.7; 1.5–4.8), whereas patients younger than 65 years (OR 2.0; 1.7–2.4), nondrinkers (OR 2.0; 1.6–2.4) and HIV-negative patients (OR 1.9; 1.6–2.5 3) were two times more likely to be successfully treated.

Conclusion

The success of TB treatment at the global level was good, but was still below the defined threshold of 85%. Factors such as age, sex, alcohol consumption, smoking, lack of sputum conversion at two months of treatment and HIV affected the success of TB treatment.

Klíčová slova:

Alcohol consumption – Drug therapy – Extensively drug-resistant tuberculosis – China – Sputum – Tuberculosis


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