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Introduction <p> Drug-resistant tuberculosis (DR-TB) has emerged as a major global public health concern, particularly in developing countries, due to its significant morbidity and mortality. Understanding the distribution of DR-TB in relation to socioeconomic and clinical characteristics is essential for informing effective disease control strategies.</p> Objective <p>To evaluate five-year survival and its associated factors among patients undergoing treatment for DR-TB.</p> Methods <p>A retrospective cohort study was conducted including 978 patients treated at a referral hospital in the Amazon region between 2004 and 2018. Patients were followed for five years. Data were collected from the Brazilian Special Tuberculosis Treatment Information System. The Cochran-Mantel-Haenszel test and Cox proportional hazards regression model were used to identify risk factors associated with five-year survival. P-value &lt; 0.05 were considered predictors of patient survival.</p> Results <p>Most patients were male (65.03%) and under 40 years of age. Primary resistance was observed in 32.62% of cases, while 67.38% presented acquired resistance. Additionally, 9.03% of the cohort was HIV-positive. The main predictors of reduced survival included HIV coinfection (HR = 0.222), low body mass index (HR = 0.327), illicit drug use (HR = 7.623), and clinical form of the disease (HR = 0.018). The Cox model demonstrated good fit, as indicated by Schoenfeld residual analysis.</p> Conclusion <p>These findings underscore the need for targeted interventions for vulnerable populations, eincluding nutritional support and public health policies aimed at the prevention and management of comorbidities such as TB-HIV coinfection.</p>

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Survival and Associated Factors in People Receiving Treatment for Drug-Resistant Tuberculosis in the Amazon: A Five-Year Retrospective Cohort Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月20日

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  • Ana Raquel Gouveia Vasconcelos,
  • Kamila da Silva Teles Gonçalves,
  • Maria Fernanda de Carvalho Dias,
  • João Tássio Barros Félix,
  • Kaliana Kennedy Oliveira Calixto,
  • Saul Rassy Carneiro,
  • Carlos Augusto Abreu Alberio,
  • Maria da Conceição Nascimento Pinheiro

摘要

Introduction

Drug-resistant tuberculosis (DR-TB) has emerged as a major global public health concern, particularly in developing countries, due to its significant morbidity and mortality. Understanding the distribution of DR-TB in relation to socioeconomic and clinical characteristics is essential for informing effective disease control strategies.

Objective

To evaluate five-year survival and its associated factors among patients undergoing treatment for DR-TB.

Methods

A retrospective cohort study was conducted including 978 patients treated at a referral hospital in the Amazon region between 2004 and 2018. Patients were followed for five years. Data were collected from the Brazilian Special Tuberculosis Treatment Information System. The Cochran-Mantel-Haenszel test and Cox proportional hazards regression model were used to identify risk factors associated with five-year survival. P-value < 0.05 were considered predictors of patient survival.

Results

Most patients were male (65.03%) and under 40 years of age. Primary resistance was observed in 32.62% of cases, while 67.38% presented acquired resistance. Additionally, 9.03% of the cohort was HIV-positive. The main predictors of reduced survival included HIV coinfection (HR = 0.222), low body mass index (HR = 0.327), illicit drug use (HR = 7.623), and clinical form of the disease (HR = 0.018). The Cox model demonstrated good fit, as indicated by Schoenfeld residual analysis.

Conclusion

These findings underscore the need for targeted interventions for vulnerable populations, eincluding nutritional support and public health policies aimed at the prevention and management of comorbidities such as TB-HIV coinfection.