Risk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting

Kevin Montes, Himachandana Atluri, Hibeb Silvestre Tuch, Lucrecia Ramirez, Juan Paiz, Ana Hesse Lopez, Thomas C. Bailey, Andrej Spec, Carlos Mejia-Chew

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Risk factors for mortality and MDR-TB in Guatemala are poorly understood. We aimed to identify risk factors to assist in targeting public health interventions. Methods: We performed a retrospective study of adults with pulmonary TB reported to the Guatemalan TB Program between January 1, 2016 and December 31, 2017. The primary objective was to determine risk factors for mortality in pulmonary TB. The secondary objective was to determine risk factors associated with MDR-TB. Results: Among 3,945 patients with pulmonary TB, median age was 39 years (IQR 25–54), 59% were male, 25% of indigenous ethnicity, 1.1% had MDR-TB and 3.9% died. On multivariable analysis, previous TB treatment (odds ratio [OR] 3.57, CI 2.24–5.68 [p < 0.001]), living with HIV (OR 3.98, CI 2.4–6.17 [p < 0.001]), unknown HIV diagnosis (OR 2.65, CI 1.68–4.18 [p < 0.001]), indigenous ethnicity (OR 1.79, CI 1.18–2.7 [p = 0.005]), malnutrition (OR 7.33, CI 3.24–16.59 [p < 0.001]), and lower educational attainment (OR 2.86, CI 1.43–5.88 [p = 0.003]) were associated with mortality. Prior treatment (OR 53.76, CI 25.04–115.43 [p < 0.001]), diabetes (OR 4.13, CI 2.04–8.35 [p < 0.001]), and indigenous ethnicity (OR 11.83, CI 1.46–95.73 [p = 0.02]) were associated with MDR-TB. Conclusions: In Guatemala, both previous TB treatment and indigenous ethnicity were associated with higher TB mortality and MDR-TB risk among patients with pulmonary TB.

Original languageEnglish
Article number100287
JournalJournal of Clinical Tuberculosis and Other Mycobacterial Diseases
Volume25
DOIs
StatePublished - Dec 2021

Keywords

  • Central America
  • Guatemala
  • MDR-TB
  • Mortality
  • Risk factors

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