scholarly journals Risk Factors for Mortality Among Patients Diagnosed With Multi-Drug Resistant Tuberculosis In Uganda- A Case-Control Study

2020 ◽  
Author(s):  
Enock Kizito ◽  
Joseph Musaazi ◽  
Kenneth Mutesasira ◽  
Fred Twinomugisha ◽  
Helen Namwanje ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
World Health ◽  
Incidence Density ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Control Study

Abstract Background:The World Health Organization (WHO) End TB strategy aims to reduce mortality due to tuberculosis (TB) to less than 5% by 2035. However, mortality due to multidrug-resistant tuberculosis (MDR-TB) is particularly high and stood at 15% globally in 2018. In Uganda, MDR-TB associated mortality was 19% in the same year. We set out to examine the risk factors for mortality among a cohort of patients diagnosed with MDR-TB in Uganda.Methods:We conducted a case-control study nested within the national MDR-TB cohort. We defined cases as patient who died from any cause during the two years following treatment initiation. We selected two controls for each case from patients alive and on MDR-TB treatment at the time that the death occurred (incidence-density sampling) and matched the cases and controls on health facility at which they were receiving care. We performed conditional logistic regression to identify the risk factors for mortality. Results:Data from 198 patients (66 cases and 132 controls) started on TB from January 1 to December 31, 2016, was analyzed for this study. Majority of patients (60.6%) were male and were HIV positive (59.6%). About half (46.0%) were aged 19-34 years. On multiple regression analysis, co-infection with HIV (aOR 1.9, 95% CI [1.1-4.92]p=0.05); non-adherence to TB treatment (aOR 1.92, 95% CI [1.02-4.83] p=0.04); age over 50 years (aOR 3.04, 95% CI [1.13-8.20] p=0.03); and not having any education (aOR 3.61, 95% CI [1.1-10.4] p=0.03) were associated with MDR TB mortality. Conclusion: To improve MDR-TB treatment outcomes, to attention must be paid to provision of social support particularly for older persons on MDR TB treatment. Interventions that support treatment adherence and promote early detection of HIV infection should also be emphasized for all persons diagnosed with TB.

scholarly journals Risk factors for mortality among patients diagnosed with multi-drug resistant tuberculosis in Uganda- a case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Enock Kizito ◽  
Joseph Musaazi ◽  
Kenneth Mutesasira ◽  
Fred Twinomugisha ◽  
Helen Namwanje ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
World Health ◽  
Incidence Density ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Control Study

Abstract Background The World Health Organization (WHO) End TB strategy aims to reduce mortality due to tuberculosis (TB) to less than 5% by 2035. However, mortality due to multidrug-resistant tuberculosis (MDR-TB) remains particularly high. Globally, almost 20% of patients started on MDR-TB treatment die during the course of treatment every year. We set out to examine the risk factors for mortality among a cohort of patients diagnosed with MDR-TB in Uganda. Methods We conducted a case-control study nested within the national MDR-TB cohort. We defined cases as patients who died from any cause during the course of MDR-TB treatment. We selected two controls for each case from patients alive and on MDR-TB treatment at the time that the death occurred (incidence-density sampling). We matched the cases and controls on health facility at which they were receiving care. We performed conditional logistic regression to identify the risk factors for mortality. Results Data from 198 patients (66 cases and 132 controls) started on MDR-TB treatment from January 1 to December 31, 2016, was analyzed for this study. Cases were similar to controls in age/sex distribution, occupation and history of TB treatment. However, cases were more likely to be HIV infected while controls were more likely to have attained secondary level education. On multivariate regression analysis, co-infection with HIV (aOR 1.9, 95% CI [1.1–4.92] p = 0.05); non-adherence to MDR-TB treatment (aOR 1.92, 95% CI [1.02–4.83] p = 0.04); age over 50 years (aOR 3.04, 95% CI [1.13–8.20] p = 0.03); and having no education (aOR 3.61, 95% CI [1.1–10.4] p = 0.03) were associated with MDR-TB mortality. Conclusion To mitigate MDR-TB mortality, attention must be paid to provision of social support particularly for older persons on MDR-TB treatment. In addition, interventions that support treatment adherence and promote early detection and management of TB among HIV infected persons should also be emphasized.

scholarly journals Assessment of the risk factors associated with multidrug-resistant tuberculosis in Sudan: a case-control study

2019 ◽  
Vol 41 ◽  
pp. e2019014 ◽  
Author(s):  
Adel Hussein Elduma ◽  
Mohammad Ali Mansournia ◽  
Abbas Rahimi Foroushani ◽  
Hamdan Mustafa Hamdan Ali ◽  
Asrar M A Salam Elegail ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Multidrug Resistant ◽  
Water Pipe ◽  
Factors Associated ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Control Study

OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients’ adherence to treatment, and to reduce contact with MDR-TB patients.

scholarly journals A case control study in BMC Sagar to identify the risk factors for heart failure in patients with recently diagnosed myocardial infarction

2017 ◽  
Vol 4 (5) ◽  
pp. 1222
Author(s):  
Ramesh Pandey ◽  
Shikha Pandey
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Madhya Pradesh ◽  
Incidence Density ◽  
Potential Risk Factors ◽  
Control Study

Background: This study was conducted to identify the risk factors for heart failure (HF) in recently diagnosed myocardial infarction (MI) patients in Bundelkhand region of Madhya Pradesh, India.Methods: In this hospital-based, case-control study, the participants were all new myocardial infarction patients hospitalized from April 2016 to March 2017 in Bundelkhand Medical College (BMC) and associated hospital Sagar, Madhya Pradesh. There were 1,691 new cases with heart failure and 6,764 patients without heart failure as controls. Controls were selected randomly as per incidence density sampling. Odds ratios (ORs) with a 95% confidence interval (CI) was calculated to identify potential risk factors, using conditional logistic regression models.Results: The mortality rate was 18.2% in the cases and (12.1%) in the controls (p<0.05). Important risk factors for heart failure were: stroke (OR, 2.00; 95% CI, 1.39 to 2.89), and right bundle branch block (RBBB) (OR, 2.86; 95% CI, 1.95 to 4.19). The factors significantly associated with heart failure Diabetes, hypertension, atrial fibrillation, ventricular tachycardia, and age. Incidence (p<0.05). Significant factor in women was diabetes (OR, 1.41; 95% CI, 1.05 to 1.88) while in men age, hypertension, and RBBB are important.Conclusions: This study might help to identify and monitor the predictive risk factors for heart failure in myocardial infarction patients. The type of risk factors was different in men and women.  

scholarly journals Correlates of multi-drug resistant tuberculosis: a case control study from a hilly district of North India

2017 ◽  
Vol 4 (7) ◽  
pp. 2613
Author(s):  
Salig Ram Mazta ◽  
Harshvardhan Singh ◽  
Prem Lal
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Drug Resistant ◽  
Private Practitioners ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Poor Ventilation ◽  
Incomplete Treatment ◽  
Control Study

Background: Drug resistance has emerged as a major threat to global TB control efforts in recent years. India, with the highest burden of Tuberculosis worldwide, faces a looming epidemic of drug resistant TB due to initial irrational, irregular and incomplete treatment outside the purview of the robust national programme. Himachal Pradesh, a north Indian hilly state with a population of about 7 million has a considerable burden of Tuberculosis with geographical challenges. The present study envisaged to identify the potential risk factors to the emergence of drug resistance TB in the settings of district Shimla.Methods: A pilot case control study, all patients (n=11) enrolled for MDR-TB in Tuberculosis Unit Shimla during the period (2013-14) were included. 3 of who died were excluded. Thrice the number of controls (n=24) were selected after matching for age, sex and approximate geographical location.Results: The univariate analysis showed that, compared with controls, risk factors significantly associated with primary MDR-TB were Socioeconomic status lower than class 3 (OR=13.8; p=0.02), poor ventilation (OR=5; p=0.05), absent BCG scar (OR=23; p=0.002), history of default (p=0.002) and initial treatment from a private practitioner (OR=6.60; p=0.04). The Multivariate analysis showed that the risk factors independently associated with primary MDR-TB were absent BCG scar (OR=28.15; 95% CI=1.51524.38) and initial irrational and incomplete treatment from a private practitioner (OR=16.77; 95% CI =1.12-319.26).Conclusions: In our stud, poor ventilation, lower socioeconomic condition and initial default have been found to be significantly associated with the disease whereas absent BCG scar and initial irrational treatment from private practitioners have emerged as independent risk factors for the emergence of drug resistant Tuberculosis further reiterating the need for strengthening Immunization and early diagnosis and treatment aspect of the disease involving private practitioners. Larger and extensive studies on these aspects are further warranted.

scholarly journals Factors associated with multidrug-resistant tuberculosis (MDR-TB) in Bhutan: A nationwide case-control study

PLoS ONE ◽  
2020 ◽  
Vol 15 (7) ◽  
pp. e0236250
Author(s):  
Chador Tenzin ◽  
Natkamol Chansatitporn ◽  
Tashi Dendup ◽  
Tandin Dorji ◽  
Karma Lhazeen ◽  
...  
Keyword(s):  
Case Control Study ◽  
Multidrug Resistant ◽  
Case Control ◽  
Factors Associated ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Control Study

scholarly journals Diabetes mellitus, anti-secretory drugs and other risk factors for campylobacter gastro-enteritis in adults: a case-control study

1997 ◽  
Vol 119 (3) ◽  
pp. 307-311 ◽  
Author(s):  
K. R. NEAL ◽  
R. C. B. SLACK
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Postal Questionnaire ◽  
Foreign Travel ◽  
Drinking Milk ◽  
Campylobacter Infection ◽  
Control Study

The epidemiology of notified cases of campylobacter gastroenteritis in adults in Nottingham Health District was investigated using a case-control study with a postal questionnaire to ascertain data on risk factors. Over a 14-month period 531 cases (a 73% response rate of all laboratory confirmed cases) and 512 controls replied.Conditional logistic regression analysis was used to determine independent associations with infection. These included foreign travel (odds ratio (OR) 3·4; 95% confidence intervals (CI) 2·0–5·7), diabetes mellitus (OR 4·1, CI 1·1–17), medication with omeprazole (OR 3·5, CI 1·1–12) and H2 and H2 antagonists (OR 3·7, CI 1·3–15), contact with puppies (OR11·3, CI1·2–105), eating chicken (OR 1·4, CI 1·1–1·8) and drinking milk from bottles with tops damaged by a bird (OR 3·3, CI 1·0–11). Preparing main meals (OR 0·9, CI 0·8–1·0) and drinking delivered milk (OR 0·6, CI 0·4–0·9) were associated with a reduced risk of campylobacter infection.Foreign travel was reported in 25% of cases and another 15% had significant associations with other risk factors. The majority of cases, 60%, remained unexplained, indicating the need for further evolution of sporadic cases.

scholarly journals Potential risk factors for multiple sclerosis in Rio de Janeiro: a case-control study

2009 ◽  
Vol 67 (2a) ◽  
pp. 229-234 ◽  
Author(s):  
Kátia Regina Penha da Silva ◽  
Regina Maria Papais Alvarenga ◽  
Oscar Fernandez y Fernandez ◽  
Hélcio Alvarenga ◽  
Luiz Claudio Santos Thuler
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Potential Risk ◽  
Rio De Janeiro ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Potential Risk Factors ◽  
Epidemiological Characteristics ◽  
Control Study

PURPOSE: To evaluate potential risk factors for the development of multiple sclerosis in Brazilian patients. METHOD: A case control study was carried out in 81 patients enrolled at the Department of Neurology of the Hospital da Lagoa in Rio de Janeiro, and 81 paired controls. A standardized questionnaire on demographic, social and cultural variables, and medical and family history was used. Statistical analysis was performed using descriptive statistics and conditional logistic regression models with the SPSS for Windows software program. RESULTS: Having standard vaccinations (vaccinations specified by the Brazilian government) (OR=16.2; 95% CI=2.3-115.2), smoking (OR=7.6; 95% CI=2.1-28.2), being single (OR=4.7; 95% CI=1.4-15.6) and eating animal brain (OR=3.4; 95% CI=1.2-9.8) increased the risk of developing MS. CONCLUSIONS: RESULTS of this study may contribute towards better awareness of the epidemiological characteristics of Brazilian patients with multiple sclerosis.

scholarly journals Ecological and behavioural risk factors of scrub typhus in central Vietnam: a case-control study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hanh Thi Duc Tran ◽  
Jan Hattendorf ◽  
Hung Manh Do ◽  
Thanh Tien Hoang ◽  
Hang Thi Hai Hoang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Scrub Typhus ◽  
Conditional Logistic Regression ◽  
Febrile Illness ◽  
Case Control ◽  
Enzyme Linked Immunosorbent Assay ◽  
Protective Equipment ◽  
Related Factors ◽  
Control Study

Abstract Background The risk factors for scrub typhus in Vietnam remain unknown. Scrub typhus caused by Orientia tsutsugamushi often presents as an undifferentiated febrile illness and remains under appreciated due to the limited availability of diagnostic tests. This tropical rickettsial illness is increasingly recognized as an important cause of non-malaria acute undifferentiated fever in Asia. This study aimed to investigate behavioural and ecological related risk factors of scrub typhus to prevent this potentially life-threatening disease in Vietnam. Methods We conducted a clinical hospital-based active surveillance study, and a retrospective residence-enrolment date-age-matched case–control study in Khanh Hoa province, Vietnam, from August 2018 to March 2020. Clinical examinations, polymerase chain reaction and enzyme-linked immunosorbent assay IgM tests were applied to define cases and controls. All enrolled participants filled out a questionnaire including demographic socio-economic status, personal behaviors/protective equipment, habitat connections, land use, and possible exposure to the vector. Multivariable conditional logistic regression was used to define the scrub typhus associated risk factors. Results We identified 44 confirmed cases and matched them with 152 controls. Among cases and controls, the largest age group was the 41–50 years old and males accounted for 61.4% and 42.8%, respectively. There were similarities in demographic characteristics between the two groups, with the exception of occupation. Several factors were significantly associated with acquisition of scrub typhus, including sitting/laying directly on household floor [adjusted OR (aOR) = 4.9, 95% CI: 1.6–15.1, P = 0.006], household with poor sanitation/conditions (aOR = 7.9, 95% CI: 1.9–32.9, P = 0.005), workplace environment with risk (aOR = 3.0, 95% CI: 1.2–7.6, P = 0.020), always observing mice around home (aOR = 3.7, 95% CI: 1.4–9.9, P = 0.008), and use of personal protective equipment in the field (aOR = 0.4, 95% CI: 0.1–1.1, P = 0.076). Conclusions Ecological and household hygiene-related factors were more associated with scrub typhus infection, than individual-level exposure activities in the hyper-endemic area. These findings support local education and allow people to protect themselves from scrub typhus, especially in areas with limitations in diagnostic capacity. Graphical abstract

scholarly journals Investigating the Synergistic Interaction of Diabetes, Tobacco Smoking, Alcohol Consumption, and Hypercholesterolemia on the Risk of Pancreatic Cancer: A Case-Control Study in Italy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Giuseppe La Torre ◽  
Antonella Sferrazza ◽  
Maria Rosaria Gualano ◽  
Chiara de Waure ◽  
Gennaro Clemente ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Cancer ◽  
Alcohol Consumption ◽  
Case Control Study ◽  
Smoking Status ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Synergistic Interaction ◽  
Independent Risk Factors ◽  
Control Study

The aims of the present research are to investigate the possible predictors of pancreatic cancer, in particular smoking status, alcohol consumption, hypercholesterolemia, and diabetes mellitus, in patients with histologically confirmed pancreatic carcinoma and to examine the synergism between risk factors. A case-control study (80 patients and 392 controls) was conducted at the Teaching Hospital “Agostino Gemelli” in Rome. A conditional logistic regression was used for the statistical analysis and results were presented as odds ratio (OR) and 95% confidence intervals (95% CI). We also investigated the possible interactions between risk factors and calculated the synergism index (SI). The multivariate analysis revealed that hypercholesterolemia and alcohol consumption resulted in important risk factors for pancreatic cancer even after the adjustment for all variables (OR: 5.05, 95% CI: 2.94–8.66; OR: 2.25, 95% CI: 1.30–3.89, resp.). Interestingly, important synergistic interactions between risk factors were found, especially between ever smoking status and alcohol consumptions (SI = 17.61) as well as alcohol consumption and diabetes (SI = 17.77). In conclusion, the study confirms that hypercholesterolemia and alcohol consumption represent significant and independent risk factors for pancreatic cancer. Moreover, there is evidence of synergistic interaction between diabetes and lifestyle factors (drinking alcohol and eating fatty foods).

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