Recurrent tuberculosis in Houston, Texas: a population-based study.
2004; National Institutes of Health; Volume: 8; Issue: 3 Linguagem: Inglês
Autores
Hana M. El Sahly, John A. Wright, Hanna Soini, Thi Thu Trang Bui, Natalie Williams‐Bouyer, Patricio Escalante, James M. Musser, Edward A. Graviss,
Tópico(s)Diagnosis and treatment of tuberculosis
ResumoTo determine the predictors of recurrence of tuberculosis (TB), the drug resistance pattern of Mycobacterium tuberculosis strains recovered from recurrent TB patients, and the frequency of re-infection with a new M. tuberculosis strain among patients with recurrent disease.A population-based, retrospective case-control study using the Houston Tuberculosis Initiative database.We found that, among 100 patients with recurrent TB who completed adequate therapy for a first episode of TB, not receiving directly observed therapy, pulmonary disease, HIV/AIDS diagnosis, not having a family physician, being unemployed and using public transportation were predictors of recurrent disease. There was a significant increase in drug-resistant M. tuberculosis strains in the second episode of disease compared to the first episode (21.3% vs. 8.2%, P = 0.04). Exogenous re-infection with a new strain of M. tuberculosis was found to cause 24-31% of recurrent TB.Recurrent TB in Houston is associated with a significant increase in drug-resistant M. tuberculosis strains. Re-infection with a new M. tuberculosis strain causes a significant proportion of recurrent TB in an area of low TB incidence. Patients with HIV/AIDS constitute a population at increased risk of disease recurrence.
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