TAILIEUCHUNG - Associated factors for treatment delay in pulmonary tuberculosis in HIV-infected individuals: a nested case-control study

A nested case-control study was undertaken within a cohort of HIV-infected individuals, attended at two HIV referral centers, in the state of Pernambuco, Brazil. Delay in initiating treatment for TB was defined as the period of time, in days, which was greater than the median value between the onset of cough and initiating treatment for TB. The study analyzed biological, clinical, socioeconomic, and lifestyle factors as well as those related to HIV and TB infection, potentially associated to delay. The odds ratios were estimated with the respective confidence intervals and p-values | Coimbra et al. BMC Infectious Diseases 2012 12 208 http 1471-2334 12 208 BMC Infectious Diseases RESEARCH ARTICLE Open Access Associated factors for treatment delay in pulmonary tuberculosis in HIV-infected individuals a nested case-control study Isabella Coimbra1 Magda Maruza1 Maria de Fatima Pessoa Militão-Albuquerque Libia Vilela Moura1 George Tadeu Nunes Diniz2 Demócrito de Barros Miranda-Filho3 Heloísa Ramos Lacerda1 Laura Cunha Rodrigues4 and Ricardo Arraes de Alencar Ximenes1 Abstract Background The delay in initiating treatment for tuberculosis TB in HIV-infected individuals may lead to the development of a more severe form of the disease with higher rates of morbidity mortality and transmissibility. The aim of the present study was to estimate the time interval between the onset of symptoms and initiating treatment forTB in HIV-infected individuals and to identify the factors associated to this delay. Methods A nested case-control study was undertaken within a cohort of HIV-infected individuals attended at two HIV referral centers in the state of Pernambuco Brazil. Delay in initiating treatment for TB was defined as the period of time in days which was greater than the median value between the onset of cough and initiating treatment for TB. The study analyzed biological clinical socioeconomic and lifestyle factors as well as those related to HIV and TB infection potentially associated to delay. The odds ratios were estimated with the respective confidence intervals and p-values. Results From a cohort of 2365 HIV-infected adults 274 presented pulmonary TB and of these 242 participated in the study. Patients were already attending 2 health services at the time they developed a cough period range 1 - 552 days with a median value of 41 days. Factors associated to delay were systemic symptoms asthenia chest pain use of illicit drugs and sputum smear-negative. Conclusion The present study indirectly showed the difficulty of diagnosing TB in

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