학술논문
Outcomes with a shorter multidrug-resistant tuberculosis regimen from Karakalpakstan, Uzbekistan
Document Type
article
Author
Philipp du Cros; Atadjan Khamraev; Zinaida Tigay; Tleubergen Abdrasuliev; Jane Greig; Graham Cooke; Krzysztof Herboczek; Tanya Pylypenko; Catherine Berry; Amrita Ronnachit; David Lister; Sebastian Dietrich; Cono Ariti; Khasan Safaev; Bern-Thomas Nyang'wa; Nargiza Parpieva; Mirzagalib Tillashaikhov; Jay Achar
Source
ERJ Open Research, Vol 7, Iss 1 (2021)
Subject
Language
English
ISSN
2312-0541
23120541
23120541
Abstract
Background In 2016, World Health Organization guidelines conditionally recommended standardised shorter 9–12-month regimens for multidrug-resistant (MDR) tuberculosis (TB) treatment. We conducted a prospective study of a shorter standardised MDR-TB regimen in Karakalpakstan, Uzbekistan. Methods Consecutive adults and children with confirmed rifampicin-resistant pulmonary TB were enrolled between September 1, 2013 and March 31, 2015; exclusions included prior treatment with second-line anti-TB drugs, and documented resistance to ofloxacin or to two second-line injectable agents. The primary outcome was recurrence-free cure at 1 year following treatment completion. Results Of 146 enrolled patients, 128 were included: 67 female (52.3%), median age 30.1 (interquartile range 23.8–44.4) years. At the end of treatment, 71.9% (92 out of 128) of patients achieved treatment success, with 68% (87 out of 128) achieving recurrence-free cure at 1 year following completion. Unsuccessful outcomes during treatment included 22 (17.2%) treatment failures with fluoroquinolone-resistance amplification in 8 patients (8 out of 22, 36.4%); 12 (9.4%) lost to follow-up; and 2 (1.5%) deaths. Recurrence occurred in one patient. Fourteen patients (10.9%) experienced serious adverse events. Baseline resistance to both pyrazinamide and ethambutol (adjusted OR 6.13, 95% CI 2.01; 18.63) and adherence