‘Out of sight, out of mind?’ A follow-up on HIV-infected patients with drug-resistant pulmonary tuberculosis in Uganda: A case series

Among new tuberculosis cases in Uganda, 10.3% are drug-resistant and 43% occur in people living with HIV. Both resistance and HIV–tuberculosis co-infection lead to unfavourable tuberculosis treatment outcomes. In this case series, we followed up eight HIV–tuberculosis co-infected patients withdrawn from a pharmacokinetics study on anti-tuberculosis drugs between April 2013 and April 2015 following a diagnosis of drug-resistant tuberculosis. We identified resistance patterns and treatment regimens and evaluated their tuberculosis treatment outcomes. Two patients were multidrug-resistant, only one out of eight was treated according to the World Health Organization guidelines applicable at that time and five had unfavourable tuberculosis treatment outcomes, that is, were lost to follow-up, could not be evaluated or died. Taken together, we found unfavourable tuberculosis treatment outcomes for patients with drug-resistant tuberculosis. This indicates the necessity of implementation of current treatment guidelines and close monitoring for patients with drug-resistant tuberculosis.

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Trends, Characteristics and Treatment Outcomes of Patients with Drug-Resistant Tuberculosis in Uzbekistan: 2013–2018

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094663 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4663

Author(s):

Khasan Safaev ◽

Nargiza Parpieva ◽

Irina Liverko ◽

Sharofiddin Yuldashev ◽

Kostyantyn Dumchev ◽

...

Keyword(s):

Risk Factors ◽

Treatment Outcomes ◽

Treatment Success ◽

National Level ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Loss To Follow Up ◽

Resistant Tuberculosis ◽

Mdr Tb

Uzbekistan has a high burden of drug-resistant tuberculosis (TB). Although conventional treatment for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) has been available since 2013, there has been no systematic documentation about its use and effectiveness. We therefore documented at national level the trends, characteristics, and outcomes of patients with drug-resistant TB enrolled for treatment from 2013–2018 and assessed risk factors for unfavorable treatment outcomes (death, failure, loss to follow-up, treatment continuation, change to XDR-TB regimen) in patients treated in Tashkent city from 2016–2017. This was a cohort study using secondary aggregate and individual patient data. Between 2013 and 2018, MDR-TB numbers were stable between 2347 and 2653 per annum, while XDR-TB numbers increased from 33 to 433 per annum. At national level, treatment success (cured and treatment completed) for MDR-TB decreased annually from 63% to 57%, while treatment success for XDR-TB increased annually from 24% to 57%. On multivariable analysis, risk factors for unfavorable outcomes, death, and loss to follow-up in drug-resistant TB patients treated in Tashkent city included XDR-TB, male sex, increasing age, previous TB treatment, alcohol abuse, and associated comorbidities (cardiovascular and liver disease, diabetes, and HIV/AIDS). Reasons for these findings and programmatic implications are discussed.

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Impact of Xpert MTB/RIF and decentralized care on linkage to care and drug-resistant tuberculosis treatment outcomes in Johannesburg, South Africa

BMC Health Services Research ◽

10.1186/s12913-018-3762-x ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 6

Author(s):

Denise Evans ◽

Tembeka Sineke ◽

Kathryn Schnippel ◽

Rebecca Berhanu ◽

Caroline Govathson ◽

...

Keyword(s):

South Africa ◽

Treatment Outcomes ◽

Linkage To Care ◽

Tuberculosis Treatment ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Decentralized Care

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Directrices unificadas de la OMS sobre el tratamiento de la tuberculosis farmacorresistente

10.37774/9789275321867 ◽

2020 ◽

Keyword(s):

World Health Organization ◽

Tuberculosis Treatment ◽

World Health ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Health Organization

Estas directrices unificadas se han actualizado con arreglo a los procesos del grupo de elaboración de las directrices que se llevaron a cabo entre el 2011 y el 2018 de conformidad con los requisitos de la OMS. Este documento sustituye a otras recomendaciones de la OMS relativas al tratamiento de la tuberculosis (TB) multirresistente y resistente a la rifampicina (TB-MDR/RR) publicadas desde el 201. En este documento se incluyen las preguntas sobre población, intervención, comparador y resultado (PICO, por su sigla en inglés) subyacentes a las recomendaciones y la posología revisada de los medicamentos utilizados en los esquemas de segunda línea, así como las referencias clave. En línea se puede encontrar más información sobre los procesos del grupo de elaboración de las directrices y los participantes en dicho grupo, los principales métodos utilizados para desarrollar las recomendaciones, los resúmenes de la evidencia de la clasificación de la valoración, elaboración y evaluación de las recomendaciones (GRADE por su sigla en inglés) resultante y los marcos de decisión para cada recomendación, así como datos inéditos, planes de análisis de datos e informes de revisiones sistemáticas. Las recomendaciones y demás información práctica para apoyar su implementación se reproducirán en una próxima actualización del manual de la OMS sobre el manejo programático de la TB. Versión oficial en español de la obra original en inglés: WHO consolidated guidelines on drug-resistant tuberculosis treatment. © World Health Organization 2019. ISBN: 978-92-4-155052-9.

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