Factors related to non-testing of drugs in patients with pulmonary tuberculosis; Factores relacionados con la no realización de pruebas a fármacos en pacientes con tuberculosis pulmonar

Abstract

Introduction: Drug-resistant tuberculosis is a serious public health problem worldwide. Its presence is associated with more expensive treatment, with more adverse effects, and with higher rates of treatment failure and mortality, which becomes a barrier to the control and eradication of drug-resistant tuberculosis. As part of the disease control guidelines, all patients previously treated for tuberculosis should be tested for drug susceptibility, an aspect that is not always fulfilled. Objective: To determine the frequency and factors related to non-performance of drug susceptibility testing in previously treated patients with pulmonary tuberculosis. Methods: Operations research through a descriptive observational cross-sectional study of the registries of patients with pulmonary tuberculosis previously treated in Cali between 2017 and 2019. Data were obtained from the registries of the "Cali Tuberculosis Program". Results: 369 records of patients with pulmonary tuberculosis previously treated were analyzed; it was found that the frequency of not performing the drug susceptibility test was 33.79 % in 2017; 44.88% in 2018 and 48.45% in 2019. The main risk conditions related to not performing susceptibility tests to drugs were drug dependence (36.67%), street habitability (30%) and prison confinement (21.11%). The variable patients without health insurance was the only significant one in the bivariate analysis (OR of 2.31 p = 0.0014). Conclusions: To ensure that 100% of previously treated patients are tested for susceptibility to drugs, it is necessary to integrate those who participate in their timely access, guarantee the quality management of their processes and that the health personnel involved know the algorithms that the World Health Organization and the Ministry of Colombia have drawn up for the diagnosis and treatment of tuberculosis. © 2023 Elsevier B.V., All rights reserved.