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Volume 20, Number 3—March 2014
CME ACTIVITY - Research

Use of Drug-Susceptibility Testing for Management of Drug-Resistant Tuberculosis, Thailand, 2004–2008

Eugene Lam, Sriprapa Nateniyom, Sara Whitehead, Amornrat Anuwatnonthakate, Patama Monkongdee, Apiratee Kanphukiew, Jiraphan Inyaphong, Wanlaya Sitti, Navarat Chiengsorn, Saiyud Moolphate, Suporn Kavinum, Narin Suriyon, Pranom Limsomboon, Junya Danyutapolchai, Chalinthorn Sinthuwattanawibool, and Laura Jean PodewilsComments to Author 
Author affiliations: US Centers for Disease Control and Prevention (US CDC), Atlanta, Georgia, USA (E. Lam, S. Whitehead, L.J. Podewils); Thailand Ministry of Public Health (MOPH), Nonthaburi, Thailand (S. Nateniyom); Thailand MOPH–US CDC, Nonthaburi (S. Whitehead, A. Anuwatnonthakate, P. Monkongdee, A. Kanphukiew, J. Danyutapolchai, C. Sinthuwattanawibool); Office of Disease Prevention and Control 7, Ubon-ratchathani, Thailand (J. Inyaphong, W. Sitti); Bangkok Metropolitan Health Administration, Bangkok Thailand (N. Chiengsorn); Research Institute of Tuberculosis (RIT-Japan), Tokyo, Japan (S. Moolphate); Tak Provincial Public Health Office, Tak, Thailand (S. Kavinum); Chiang Rai Provincial Public Health Office, Chiang Rai, Thailand (N. Suriyon); Phuket Provincial Public Health Office, Phuket, Thailand (P. Limsomboon)

Main Article

Table 5,

Appendix Association between sociodemographic, clinical, and treatment characteristics and poor treatment outcome among 194 RIF-resistant and MDR TB patients, Thailand 2004–2008*

Characteristic Poor outcome/total outcomes† Analysis, odds ratio (95% CI)
Univariate p Multivariate‡ p
Age, y
<45 28/76 (36.8) Reference
>45
43/118 (36.4)
0.98 (0.5–1.8)
0.96



Sex
M 47/126 (37.3) Reference
F
24/68 (35.2)
0.92 (0.5–1.7)
0.78



Marital status
Married 31/106 (29.3) Reference Reference
Single/divorced/widowed
40/87 (46.0)
2.1 (1.1–3.7)
0.02

2.3 (1.2–4.6)
0.01
Nationality
Thai 57/164 (34.8) Reference
Not Thai
14/30 (46.7)
1.6 (0.7–3.6)
0.22



Case status
New 38/111 (34.2) Reference
Retreatment 27/64 (42.2) 1.4 (0.7–2.6) 0.30
Transfer in/other
6/19 (31.6)
0.89 (0.3–2.5)
0.82



Site of TB
Pulmonary 65/179 (36.3) Reference
Extrapulmonary or both
6/15 (40.0)
1.2 (0.4–3.4)
0.78



Cough >2 wk
No 21/49 (42.9) Reference
Yes
50/145 (34.5)
0.70 (0.4–1.4)
0.29



Smear status
Negative 9/27 (33.3) Reference
Positive
60/159 (37.7)
1.2 (0.5–2.9)
0.66



Cavitation seen on chest x-ray
No 48/127 (37.8) Reference
Yes
14/37 (37.8)
1.0 (0.5–2.1)
1.0



HIV status
Negative 37/125 (29.6) Reference Reference
Positive
28/57 (49.1)
2.3 (1.2–4.4)
0.01

2.2 (1.2–4.6)
0.04
Resistance pattern
RIF 8/34 (23.5) Reference
MDR
63/160 (39.4)
2.1 (0.9–5.0)
0.09



DOT
Health care worker 21/65 (32.3) Reference
Family/other 45/112 (40.2) 1.4 (0.7–2.7) 0.30
None
5/17 (29.4)
0.87 (0.3–2.8)
0.82



Category II treatment
None 50/155 (32.3) Reference Reference
Pre-DST only 15/26 (57.7) 2.9 (1.2–6.7) 0.02 2.5 (1.1–6.4) 0.05
Post-DST/ full treatment course
4/9 (44.4)
1.7 (0.4–6.5)
0.45

2.8 (0.7–11.6)
0.16
Delay from sputum collection to first post-DST visit, d
35–74 10/33 (30.3) Reference
75–112 5/31 (16.1) 0.44 (0.1–1.5) 0.19
113–155 8/36 (22.2) 0.66 (0.2–1.9) 0.44
>155 7/32 (21.9) 0.64 (0.2–2.0) 0.44

*Patients were from the Thailand TB Active Surveillance Network and were restricted to those from the current study for whom final treatment outcomes were available (excluding transferred out, still receiving treatment). RIF, rifampin; MDR TB, multidrug-resistant tuberculosis; DOT, directly observed treatment; DST, drug-susceptibility testing.
†Poor treatment outcome included treatment failure, default, and death. Data are no. patients with poor outcome/no. patients total unless otherwise specified.
‡Adjusted for age as a continuous variable.

Main Article

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Page updated: February 25, 2014
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