Share This Article:

Unbiased Multirresistance Prevalences in Real Testing Practices? An Intuitive Correcting Approach Applied to Tuberculosis in Portugal

Abstract Full-Text HTML XML Download Download as PDF (Size:1817KB) PP. 79-89
DOI: 10.4236/jtr.2014.22010    3,771 Downloads   4,671 Views  

ABSTRACT

Background: Antibiotics resistance threats Tuberculosis control, being crucial to work on unbiased MDR-TB images. The decision of testing is clinical, non-random, raising extrapolation problems. Aim: To evince and describe non-random testing practices; develop and apply a coherent and intuitive method for estimating global corrected resistance prevalences (2000-2009). Methods: A quantitative approach upon National Tuberculosis Database was undertaken, to assess testing potential predicting factors. Different factors structures in tested and non-tested cases were characterized (regarding socio-demographic and clinical variables), through binary logistic regressions. Estimated multirresistance prevalences were corrected using the essayed model. Results: Only 32% of cases had been tested, where MDR-TB prevalence was 2.38%. All factors influenced the practice of testing (p < 0.05). Corrected resistance estimates in non-tested ranged 1.96% - 2.71%, and the global weighted average found ranged 2.07% - 2.51%, depending on the chosen strata structure. Conclusions: MDR-TB prevalence representation must consider patients’ characteristics influencing testing. The correction method improved prevalences interpretation substantially; corrected and conventional values were close, because tested and non-tested had similar structures. But in other settings or health problems, correcting such estimates can make a relevant difference.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Areias, C. , Briz, T. and Nunes, C. (2014) Unbiased Multirresistance Prevalences in Real Testing Practices? An Intuitive Correcting Approach Applied to Tuberculosis in Portugal. Journal of Tuberculosis Research, 2, 79-89. doi: 10.4236/jtr.2014.22010.

References

[1] WHO (2013) Global Tuberculosis Report 2013. WHO, Geneva.
[2] Maher, D. and Raviglione, M. (2005) Global Epidemiology of Tuberculosis. Clinics in Chest Medicine, 26, 167-182.
http://dx.doi.org/10.1016/j.ccm.2005.02.009
[3] Duarte, R. and Diniz, A. (2013) Programa Nacional de Luta Contra a Tuberculose Ponto da Situação Epidemiológica e de Desempenho (dados provisórios). Directorate-General of Health, Lisbon.
[4] Briz, T., Nunes, C., Alves, J. and Santos, O. (2009) O controlo da tuberculose em Portugal: Uma apreciação crítica epidemiológica global. Revista Portuguesa de Saúde Pública, 27, 19-54.
[5] Aziz, M.A., Wright, A., Laszlo, A., Muynck, A., Portaels, F., Van Deun, A., Wells, C., Nunn, P., Blanc, L. and Raviglione, M. (2006) Epidemiology of Antituberculosis Drug Resistance (the Global Project on Anti-Tuberculosis Drug Resistance Surveillance): An Updated Analysis. Lancet, 368, 2142-2154.
http://dx.doi.org/10.1016/S0140-6736(06)69863-2
[6] WHO (2003) Guidelines for Surveillance of Drug Resistance in Tuberculosis. 4th Edition, WHO, Geneva.
[7] Cohn, D.L., Bustreo, F. and Raviglione, M.C. (1994) Drug-Resistant Tuberculosis: Review of the Worldwide Situation and the WHO/IUATLD Global Surveillance Project. 121-130.
[8] Nathanson, E., Nunn, P., Uplekar, M., Floyd, K., Jaramillo, E., Lönnroth, K., Weil, D. and Raviglione, M. (2010) MDR Tuberculosis—Critical Steps for Prevention and Control. The New England Journal of Medicine, 363, 1050- 1058.
http://dx.doi.org/10.1056/NEJMra0908076
[9] Mukherjee, J.S., Rich, M.L., Socci, A.R., Joseph, J.K., Virú, F.A., Shin, S.S., Furin, J.J., Becerra, M.C., Barry, D.J., Kim, J.Y., Bayona, J., Farmer, P., Smith Fawzi, M.C. and Seung, K.J. (2004) Programmes and Principles in Treatment of Multidrug-Resistant Tuberculosis. Lancet, 363, 474-481.
http://dx.doi.org/10.1016/S0140-6736(04)15496-2
[10] Crofton, J. and Mitchison, D. (1948) Streptomycin Resistance in Tuberculosis. British Medical Journal, 4588, 1009- 1015.
http://dx.doi.org/10.1136/bmj.2.4588.1009
[11] Kochi, A., Vareldzis, B. and Styblo, K. (1993) Multi-drug-Resistant Tuberculosis and Its Control. Research in Microbiology, 73, 219-224.
[12] Stop TB Partnership (2006) The Global Plan to Stop TB. WHO 2006-2015, Geneva.
[13] Faustini, A., Hall, A.J. and Perucci, A.C. (2006) Risk Factors for Multidrug Resistant Tuberculosis in Europe: A Systematic Review. Thorax, 61,158-163.
http://dx.doi.org/10.1136/thx.2005.045963
[14] Su, W.J., Feng, J.Y., Huang, C.C. and Perng, R.P. (2008) Increasing Drug Resistance of Mycobacterium tuberculosis Isolates in a Medical Center in Northern Taiwan. Journal of the Formosan Medical Association, 107, 259-264.
http://dx.doi.org/10.1016/S0929-6646(08)60145-X
[15] WHO (2007) Multidrug and Extensively Drug-Resistant TB (M/XDR-TB) 2010. Global Report on Surveillance and Response. WHO, Geneva.
[16] Nunes, C. (2007) Tuberculosis Incidence in Portugal: Spatiotemporal Clustering. International Journal of Health Geographics, 6, 30.
http://dx.doi.org/10.1186/1476-072X-6-30
[17] Antunes, A. (2011) Programa nacional de luta contra a tuberculose. Ponto de situação 2011. Directorate-General of Health, Lisbon.
[18] DGS (2012) Programa nacional de luta contra a tuberculose. Ponto de situação 2012, DGS, Lisbon.
[19] Antunes, M.L., Aleixo-Dias, J., Antunes, A.F., Pereira, M.F., Raymundo, E. and Rodrigues, M.F. (2000) Anti-Tuberculosis Drug Resistance in Portugal. The International Journal of Tuberculosis and Lung Disease, 4, 223-231.
[20] Kim, S.J. (2005) Drug-Susceptibility Testing in Tuberculosis: Methods and Reliability of Results. The European Respiratory Journal, 25, 564-569.
http://dx.doi.org/10.1183/09031936.05.00111304
[21] Frieden, T. (2004) TOMAN’S TUBERCULOSIS: Case Detection, Treatment and Monitoring—Questions and Answers. 2nd Edition, Geneva.
[22] WHO (2008) Stop TB Policy Paper: Contributing to Health System Strengthening. Guiding Principles for National Tuberculosis Programes. WHO, Geneva.
[23] Arghya, R. (2012) The Methodology of Sampling and Purposive Sampling. Munich.
[24] Sharp, M. and Corp, D. (2012) Tuberculosis. The Merck Manual for Health Professionals.
http://www.merckmanuals.com/professional/infectious_diseases/mycobacteria/tuberculosis_tb.html#v1010771 http://dx.doi.org/10.1016/S0140-6736(82)91579-3
[25] Bernadt, M.W., Taylor, C., Mumford, J., Smith, B. and Murray, R.M. (1982) Comparison of Questionnaire and Laboratory Tests in the Detection of Excessive Drinking and Alcoholism. The Lancet, 319, 325-328.
[26] WHO (2013) Tuberculosis Country Profiles. WHO, Geneva.
http://www.who.int/tb/country/data/profiles/en/index.html
[27] Cohen, T., Colijn, C., Finklea, B., Wright, A., Zignol, M., Pym, A. and Murray, M. (2008) Are Survey-Based Estimates of the Burden of Drug Resistant TB Too Low? Insight from a Simulation Study. PloS One, 3, e2363.
http://dx.doi.org/10.1371/journal.pone.0002363
[28] Briz, T., Areias, C., Filipe, P. and Nunes, C. (2012) Tuberculosis Control in Portugal and Resistances to Antibiotics: How to Interpret Multirresistance Prevalences in the Context of Real Testing Practices? European Journal of Epidemiology, 27, OC 2.2.2.

  
comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.