Patient- and provider-related factors in the success of multidrug tuberculosis treatment in Colombia/Factores de exito del tratamiento de la tuberculosis multidrogorresistente relacionados con el paciente y el personal sanitario en Colombia/Fatores de exito do tratamento da tuberculose multirresistente relacionados com o paciente e com a equipe de saude na Colombia

• Published in: Revista panamericana de salud pública 2021-01, Vol.45
• Main Authors: Castro, Gloria Mercedes Puerto, Zuluaga, Fernando Nicolas Montes, Alcalde- Rabanal, Jacqueline Elizabeth, Perez, Freddy
• Format: Article
• Language: Spanish
• ISSN: 1020-4989
• DOI: 10.26633/RPSP.2021.5

Objective. To identify patient- and provider-related factors associated with the success of multidrug-resistant tuberculosis (MDR-TB) treatment in the six municipalities of Colombia with the highest number of MDR-TB cases. Methods. Bivariate and multivariate logistic regressions were used to analyze the association between treatment success (cure or treatment completion) and characteristics of the patients and physicians, nursing professionals, and psychologists involved in their treatment. The importance of knowledge in the management of MDR-TB cases was explored through focus groups with these providers. Results. Of 128 cases of TB-MDR, 63 (49.2%) experienced treatment success. Only 52.9% of the physicians and nursing professionals had satisfactory knowledge about MDR-TB. Logistic regression showed that being HIV negative, being affiliated with the contributory health insurance scheme, being cared for by a male physician, and being cared for by nursing professionals with sufficient knowledge were associated with a successful treatment outcome (p [less than or equal to] 0.05). Qualitative analysis showed the need for in-depth, systematic training of health personnel who care for patients with MDR-TB. Conclusions. Some characteristics of patients and healthcare providers influence treatment success in MDR-TB cases. Physicians' and nurses' knowledge about MDR-TB must be improved, and follow-up of MDR-TB patients who are living with HIV and of those affiliated with the subsidized health insurance scheme in Colombia must be strengthened, as these patients have a lower likelihood of a successful treatment outcome. Keywords Tuberculosis; drug resistance, multiple, bacterial; health personnel; health human resource training; Colombia. Objetivo. Identificar los factores asociados con el exito del tratamiento de tuberculosis multidrogorresistente (TB-MDR) relacionados con los pacientes y el personal sanitario en seis municipios de Colombia con mayor numero de casos. Metodos. Mediante regresiones logisticas bifactorial y multifactorial se analizo la asociacion entre el tratamiento exitoso (curacion o cumplimiento del tratamiento) y las caracteristicas de los pacientes, y de los medicos, profesionales de enfermeria y psicologos vinculados al tratamiento. Se exploro la importancia del conocimiento en el manejo de los casos de TB-MDR mediante grupos focales con esos profesionales. Resultados. De los 128 casos con TB-MDR, 63 (49,2%) tuvieron un tratamiento exitoso. Sol