Factors associated with tuberculosis treatment delay in patients co-infected with HIV in a high prevalence area in Brazil.

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  • Additional Information
    • Author-Supplied Keywords:
      Academic skills
      Bacterial diseases
      Biology and life sciences
      Brazil
      Cognitive psychology
      Cognitive science
      Diagnostic medicine
      Geographical locations
      HIV
      HIV clinical manifestations
      HIV diagnosis and management
      Immunodeficiency viruses
      Infectious diseases
      Lentivirus
      Literacy
      Medical microbiology
      Medicine and health sciences
      Microbial pathogens
      Microbiology
      Neuroscience
      Organisms
      Pathogens
      Pathology and laboratory medicine
      People and places
      Psychology
      Research Article
      Retroviruses
      RNA viruses
      Social sciences
      South America
      Tropical diseases
      Tuberculosis
      Tuberculosis diagnosis and management
      Viral load
      Viral pathogens
      Viral transmission and infection
      Virology
      Viruses
    • Abstract:
      Background: Worldwide, about 11% of Tuberculosis (TB) cases occur in people living with HIV (PLHIV) and it is the leading cause of death in this population. An important step towards reducing the incidence and mortality of TB in PLHIV is to reduce the time from onset of symptoms to treatment. Factors related to TB treatment delay therefore need to be understood. Methods: Using data from a prospective cohort study of patients diagnosed with TB at the National Institute of Infectious Disease, at the Oswaldo Cruz Foundation, Rio de Janeiro, Brazil we conducted a survival analysis to identify factors associated with patient and health care treatment delay. In our analysis we included patients who were co-infected with TB and HIV (n = 201). Patients were followed during the course of their TB treatment and information regarding duration of symptoms, sociodemographics and clinical characteristics were collected at the baseline visit. Results: The median time from onset of initial symptoms to prescription of TB treatment (total delay) was 82 days. From initiation of symptoms to first visit at INI clinic (patient delay), the median was 51 days. From first visit to initiation of treatment (health care delay) the median was 16 days. Illiteracy was associated with greater patient delay [Hazard Ratio (HR) = 2.25, CI 95% 1.29–3.94]. Having had a previous episode of TB (HR = 0.53, CI 95% 0.37–0.74) and being married (HR = 0.71, CI 95% 0.54–0.94) were inversely related to patient delay. Illiteracy was also associated with greater health care delay (HR = 2.83, CI 95% 1.25–5.47) in contrast to high viral load (HR = 0.37, CI 95% 0.24–0.54) and weight loss greater than 10% (HR = 0.54, CI 95% 0.37–0.8), both of which were inversely related to health care delay. Conclusions: This study highlights the existence of factors that lead to greater risk of delayed treatment of TB among patients co-infected with HIV and TB. These include factors that can be assessed through targeted interventions which have implications for improving treatment outcomes and, through reduced duration of infectiousness, reduce the incidence of TB in Brazil. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1Division of Epidemiology and Biostatistics, San Diego State University, San Diego, California, United States of America
      2Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
      3Division of Infectious Diseases, University of California San Diego, La Jolla, California, United States of America
    • Full Text Word Count:
      8006
    • ISSN:
      1932-6203
    • Accession Number:
      10.1371/journal.pone.0195409
    • Accession Number:
      128925334
  • Citations
    • ABNT:
      NOGUEIRA, B. M. F. et al. Factors associated with tuberculosis treatment delay in patients co-infected with HIV in a high prevalence area in Brazil. PLoS ONE, [s. l.], v. 13, n. 4, p. 1–14, 2018. DOI 10.1371/journal.pone.0195409. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=aph&AN=128925334. Acesso em: 20 fev. 2020.
    • AMA:
      Nogueira BMF, Rolla VC, Akrami KM, Kiene SM. Factors associated with tuberculosis treatment delay in patients co-infected with HIV in a high prevalence area in Brazil. PLoS ONE. 2018;13(4):1-14. doi:10.1371/journal.pone.0195409.
    • APA:
      Nogueira, B. M. F., Rolla, V. C., Akrami, K. M., & Kiene, S. M. (2018). Factors associated with tuberculosis treatment delay in patients co-infected with HIV in a high prevalence area in Brazil. PLoS ONE, 13(4), 1–14. https://doi.org/10.1371/journal.pone.0195409
    • Chicago/Turabian: Author-Date:
      Nogueira, Betânia M. F., Valéria C. Rolla, Kevan M. Akrami, and Susan M. Kiene. 2018. “Factors Associated with Tuberculosis Treatment Delay in Patients Co-Infected with HIV in a High Prevalence Area in Brazil.” PLoS ONE 13 (4): 1–14. doi:10.1371/journal.pone.0195409.
    • Harvard:
      Nogueira, B. M. F. et al. (2018) ‘Factors associated with tuberculosis treatment delay in patients co-infected with HIV in a high prevalence area in Brazil’, PLoS ONE, 13(4), pp. 1–14. doi: 10.1371/journal.pone.0195409.
    • Harvard: Australian:
      Nogueira, BMF, Rolla, VC, Akrami, KM & Kiene, SM 2018, ‘Factors associated with tuberculosis treatment delay in patients co-infected with HIV in a high prevalence area in Brazil’, PLoS ONE, vol. 13, no. 4, pp. 1–14, viewed 20 February 2020, .
    • MLA:
      Nogueira, Betânia M. F., et al. “Factors Associated with Tuberculosis Treatment Delay in Patients Co-Infected with HIV in a High Prevalence Area in Brazil.” PLoS ONE, vol. 13, no. 4, Apr. 2018, pp. 1–14. EBSCOhost, doi:10.1371/journal.pone.0195409.
    • Chicago/Turabian: Humanities:
      Nogueira, Betânia M. F., Valéria C. Rolla, Kevan M. Akrami, and Susan M. Kiene. “Factors Associated with Tuberculosis Treatment Delay in Patients Co-Infected with HIV in a High Prevalence Area in Brazil.” PLoS ONE 13, no. 4 (April 6, 2018): 1–14. doi:10.1371/journal.pone.0195409.
    • Vancouver/ICMJE:
      Nogueira BMF, Rolla VC, Akrami KM, Kiene SM. Factors associated with tuberculosis treatment delay in patients co-infected with HIV in a high prevalence area in Brazil. PLoS ONE [Internet]. 2018 Apr 6 [cited 2020 Feb 20];13(4):1–14. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=aph&AN=128925334