scholarly journals Malabsorption syndrome as a manifestation of systemic effects in advanced forms of pulmonary tuberculosis

2014 ◽  
Vol 18 (3 (71)) ◽  
Author(s):  
L. D. Todoriko ◽  
I. V. Yeremenchuk ◽  
V. P. Shapovalov ◽  
T. I. Ilchyshyn
Keyword(s):  
South Africa ◽  
Epidemiological Surveillance ◽  
Systemic Effects ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Multi Drug Resistant Tuberculosis ◽  
The World ◽  
Mdr Tb

As of October 2012 84 countries had reported at least 1 case of extensively drug resistant tuberculosis (EDR TB). In November 2012, the WHO epidemiological surveillance stated: all new TB cases in the world are 3,7 % of multi-drug resistant tuberculosis (MDR TB); 60,0 % of MDR TB among the new cases of TB are documented in Brazil, China, India, and South Africa.

scholarly journals Cost-effectiveness of bedaquiline, pretomanid and linezolid for treatment of extensively drug-resistant tuberculosis in South Africa, Georgia and the Philippines

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051521
Author(s):  
Gabriela Beatriz Gomez ◽  
Mariana Siapka ◽  
Francesca Conradie ◽  
Norbert Ndjeka ◽  
Anna Marie Celina Garfin ◽  
...  
Keyword(s):  
South Africa ◽  
Cost Effectiveness ◽  
Standard Of Care ◽  
The Philippines ◽  
List Price ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Mdr Tb

ObjectivesPatients with highly resistant tuberculosis have few treatment options. Bedaquiline, pretomanid and linezolid regimen (BPaL) is a new regimen shown to have favourable outcomes after six months. We present an economic evaluation of introducing BPaL against the extensively drug-resistant tuberculosis (XDR-TB) standard of care in three epidemiological settings.DesignCost-effectiveness analysis using Markov cohort model.SettingSouth Africa, Georgia and the Philippines.ParticipantsXDR-TB and multidrug-resistant tuberculosis (MDR-TB) failure and treatment intolerant patients.InterventionsBPaL regimen.Primary and secondary outcome measures(1) Incremental cost per disability-adjusted life years averted by using BPaL against standard of care at the Global Drug Facility list price. (2) The potential maximum price at which the BPaL regimen could become cost neutral.ResultsBPaL for XDR-TB is likely to be cost saving in all study settings when pretomanid is priced at the Global Drug Facility list price. The magnitude of these savings depends on the prevalence of XDR-TB in the country and can amount, over 5 years, to approximately US$ 3 million in South Africa, US$ 200 000 and US$ 60 000 in Georgia and the Philippines, respectively. In South Africa, related future costs of antiretroviral treatment (ART) due to survival of more patients following treatment with BPaL reduced the magnitude of expected savings to approximately US$ 1 million. Overall, when BPaL is introduced to a wider population, including MDR-TB treatment failure and treatment intolerant, we observe increased savings and clinical benefits. The potential threshold price at which the probability of the introduction of BPaL becoming cost neutral begins to increase is higher in Georgia and the Philippines (US$ 3650 and US$ 3800, respectively) compared with South Africa (US$ 500) including ART costs.ConclusionsOur results estimate that BPaL can be a cost-saving addition to the local TB programmes in varied programmatic settings.

scholarly journals Evolving rifampicin and isoniazid mono-resistance in a high multidrug-resistant and extensively drug-resistant tuberculosis region: a retrospective data analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031663
Author(s):  
Nomonde Ritta Mvelase ◽  
Yusentha Balakrishna ◽  
Keeren Lutchminarain ◽  
Koleka Mlisana
Keyword(s):  
South Africa ◽  
Diagnostic Algorithm ◽  
Multidrug Resistant ◽  
Continuous Phase ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Kwazulu Natal ◽  
Mdr Tb

ObjectivesSouth Africa ranks among the highest drug-resistant tuberculosis (DR-TB) burdened countries in the world. This study assessed the changes in resistance levels in culture confirmed Mycobacterium tuberculosis (MTB) in the highest burdened province of South Africa during a period where major changes in diagnostic algorithm were implemented.SettingThis study was conducted at the central academic laboratory of the KwaZulu-Natal province of South Africa.ParticipantsWe analysed data for all MTB cultures performed in the KwaZulu-Natal province between 2011 and 2014. The data were collected from the laboratory information system.ResultsOut of 88 559 drug susceptibility results analysed, 18 352 (20.7%) were resistant to rifampicin (RIF) and 19 190 (21.7%) showed resistance to isoniazid (INH). The proportion of rifampicin resistant cases that were mono-resistant increased from 15.3% in 2011 to 21.4% in 2014 while INH mono-resistance (IMR) showed a range between 13.8% and 21.1%. The multidrug-resistant tuberculosis (MDR-TB) rates increased from 18.8% to 23.9% and the proportion of MDR-TB cases that had extensively drug-resistant tuberculosis remained between 10.2% and 11.1%. Most drug resistance was found in females between the ages of 15 and 44 years and the northern districts bordering high MDR-TB regions had the highest MDR-TB rates.ConclusionOur findings show increasing RIF mono-resistance (RMR) and a substantial amount of IMR. This highlights a need for an initial test that detects resistance to both these drugs so as to avoid using RIF monotherapy during continuous phase of treatment in patients with IMR. Furthermore, addition of INH will benefit patients with RMR. Although DR-TB is widespread, HIV and migration influence its distribution; therefore, TB control strategies should include interventions that target these aspects.

scholarly journals Multi-drug-resistant tuberculosis (MDR-TB): Current situation in South Africa

2017 ◽  
Vol 59 (2) ◽  
pp. 5
Author(s):  
Gboyega A Ogunbanjo
Keyword(s):  
South Africa ◽  
Soviet Union ◽  
Former Soviet Union ◽  
Drug Resistant ◽  
First Line ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Previously Treated

Multi-drug-resistant tuberculosis (MDR-TB) is a form of tuberculosis (TB) infection which is resistant to treatment with at least two of the most powerful first-line anti-TB drugs, namely isoniazid and rifampicin. Globally, MDR-TB caused an estimated 480 000 new TB cases and 250 000 deaths in 2015 and accounted for 3.3% of all new TB cases worldwide.1 MDR-TB, or rifampicin-resistant TB, causes 3.9% of new TB cases and 21% of previously treated TB cases, and most MDR-TB cases occur in South America, southern Africa, India, China, and the former Soviet Union.1

scholarly journals Predictors of time to sputum culture conversion in multi-drug-resistant tuberculosis and extensively drug-resistant tuberculosis in patients at Tshepong-Klerksdorp Hospital

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Relebohile Ncha ◽  
Ebrahim Variava ◽  
Kennedy Otwombe ◽  
Mary Kawonga ◽  
Neil A. Martinson
Keyword(s):  
Sputum Culture ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
North West ◽  
Sputum Culture Conversion ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Culture Conversion

Setting: Klerksdorp-Tshepong Hospital Complex MDR-TB Unit, North-West Province, South Africa.Background: To determine the time to sputum culture conversion (TTSCC) and factors predictive of TTSCC in patients with multi-drug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in the North-West Province.Methods: A retrospective cohort study, abstracting patient demographic and clinical data, laboratory results, dates of sputum testing and sputum culture conversion results, from medical records of 526 MDR-TB and 47 XDR-TB patients started on TB treatment between 01 January 2012 and 31 December 2014. Predictors of TTSCC were determined by Cox proportional hazards regression.Results: The median age was 38 years (interquartile range 31–47) with 64% being male. Overall, 79% (449) were Human Immunodeficiency Virus (HIV)-infected. The median TTSCC was 56.5 days and 162.5 days for MDR-TB and XDR-TB patients, respectively. In the multivariate analysis, age [hazard ratio (HR): 0.89, 95% confidence interval (CI): 0.96–0.99], being underweight (HR: 0.631.61, 95% CI: 0.451.03–0.882.51), Acid Fast Bacilli (AFB) positivity (HR: 0.72, 95% CI: 0.51–1.01) and having XDR-TB (HR: 0.36. 95% CI: 0.19–0.69) were predictive of longer TTSCC.Conclusion: Predictors of TTSC allow for MDR-TB- and XDR-TB-diagnosed patients to be identified early for effective management. Those with risk factors for delayed sputum culture conversion which are being underweight and having XDR-TB should be monitored carefully during treatment so that they can achieve sputum culture conversion early.

Case 10

2020 ◽  
pp. 61-68
Author(s):  
Andrew Woodhouse
Keyword(s):  
Drug Resistant ◽  
First Line ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Insight Into

Multi-drug resistant tuberculosis (MDR-TB) is defined by resistance to both isoniazid and rifampicin, the two most effective first line anti-tuberculous drugs. Resistance to one or other drug plus resistance to other first line agents (streptomycin, pyrazinamide and ethambutol) represents an important treatment challenge. The case provides insight into the challenges faced treating MDR-TB and extensively drug-resistant tuberculosis (XDR-TB).

scholarly journals Tuberculosis in the 21st century: Challenges, endeavors and recommendations to doctors

2010 ◽  
Vol 63 (11-12) ◽  
pp. 811-815 ◽  
Author(s):  
Lidija Ristic ◽  
Milan Rancic ◽  
Milan Radovic
Keyword(s):  
21St Century ◽  
World Health ◽  
World Population ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Adequate Treatment ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Multi Drug Resistant Tuberculosis ◽  
The World

The magnitude of problem with tuberculosis lies in the fact that one third of the world population is infected by Mycobacterium tuberculosis. Even in the 21st century, tuberculosis kills more people than any other infective agent. Definition of case of resistance - the case of resistant tuberculosis is precisely defined by the recommendations of the World Health Organization as primary, initial, acquired multidrug resistant and extensively drug resistant tuberculosis. The development of resistance tuberculosis may result from the administration of monotherapy or inadequate combinations of anti-tuberculosis drugs. A possible role of doctors in the development of multi drug-resistant tuberculosis is very important. Actually, multi drug-resistant tuberculosis is a direct consequence of mistakes in prescribing chemotherapy, provision of anti-tuberculosis drugs, surveillance of the patient and decision-making regarding further treatment as well as in a wrong way of administration of anti-tuberculosis drugs. The problem of extensively drug-resistant tuberculosis in the world has become very alarming. In South Africa, extensively drug resistant tuberculosis accounts for 24% of all tuberculosis case. It can be concluded that only adequate treatment according to directly supervised short regiment for correctly categorized cases of tuberculosis can stop the escalation of multidrug or extensively drug resistant tuberculosis, which is actually an incurable illness in the 21st century.

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