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

Cristiana Areias, Teodoro Briz, Carla Nunes

Department of Epidemiology and Statistics, National School of Public Health, University NOVA of Lisbon, Lisbon, Portugal.

DOI: 10.4236/jtr.2014.22010                

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.

Keywords

Testing Practices, Tuberculosis, MDR-TB

Conflicts of Interest

The authors declare no conflicts of interest.

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