Multidrug-Resistant Tuberculosis Among Patients in Baja California, Mexico, and Hispanic Patients in California.

• Autores: Ietza Bojorquez, Richard F. W. Barnes, Jennifer Flood, Hugo López Gatell, Richard S. Garfein, Claudia E. Bäcker, Celia M. Alpuche Aranda, Joseph M. Vinetz, Antonino Catanzaro, Midori Kato-Maeda, Timothy C. Rodwell
• Localización: American journal of public health, ISSN 0090-0036, Vol. 103, Nº. 7, 2013, págs. 1301-1305
• Idioma: inglés
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• Resumen

  • Objectives. We sought to compare prevalence and determinants of multidrug-resistant tuberculosis (MDR-TB) between tuberculosis patients in Baja California, Mexico, and Hispanic patients in California. Methods. Using data from Mexico's National TB Drug Resistance Survey (2008-2009) and California Department of Public Health TB case registry (2004--2009), we assessed differences in MDR-TB prevalence comparing (1) Mexicans in Baja California, (2) Mexico-born Hispanics in California, (3) US-born Hispanics in California, and (4) California Hispanics born elsewhere. Results. MDR-TB prevalence was 2.1% in Baja California patients, 1.6% in Mexico-born California patients, 0.4% in US-born California patients, and 2.7% in Hispanic California patients born elsewhere. In multivariate analysis, previous antituberculosis treatment was associated with MDR-TB (odds ratio [OR] = 6.57; 95% confidence interval [CI] = 3.34, 12.96); Mexico-born TB patients in California (OR = 5.08; 95% CI = 1.19, 21.75) and those born elsewhere (OR = 7.69; 95% CI = 1.71, 34.67) had greater odds of MDR-TB compared with US-born patients (reference category). Conclusions. Hispanic patients born outside the US or Mexico were more likely to have MDR-TB than were those born within these countries. Possible explanations include different levels of exposure to resistant strains and inadequate treatment. [ABSTRACT FROM AUTHOR]