scholarly journals Prevalence and factors associated with non-adherence to multi-drug resistant tuberculosis (MDR-TB) treatment at Mulago National Referral Hospital, Kampala, Uganda

2021 ◽  
Vol 21 (1) ◽  
pp. 238-47
Author(s):  
Charles Batte ◽  
Martha S Namusobya ◽  
Racheal Kirabo ◽  
John Mukisa ◽  
Susan Adakun ◽  
...  
Keyword(s):  
Mulago Hospital ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Factors Associated ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
History Of ◽  
Previously Treated

Background: In Uganda, 12% of previously treated TB cases and 1.6% of new cases have MDR-TB and require specialized treatment and care. Adherence is crucial for improving MDR-TB treatment outcomes. There is paucity of information on the extent to which these patients adhere to treatment and what the drivers of non-adherence are. Methods: We conducted a cohort study using retrospectively collected routine program data for patients treated for MDR- TB between January 2012 – May 2016 at Mulago Hospital. We extracted anonymized data on non-adherence (missing 10% or more of DOT), socio-economic, demographic, and treatment characteristics of the patients. All participants were sen- sitive to MDR-TB drugs after second line Drug Susceptible Testing (DST) at entry into the study. Factors associated with non-adherence to MDR-TB treatment were determined using generalized linear models for the binomial family with log link and robust standard errors. We considered a p- value less than 0.05 as statistically significant. Results: The records of 227 MDR- TB patients met the inclusion criteria, 39.4% of whom were female, 32.6% aged be- tween 25 – 34 years, and 54.6% living with HIV/AIDS. About 11.9% of the patients were non-adherent. The main driver for non-adherence was history of previous DR-TB treatment; previously treated DR-TB patients were 3.46 (Adjusted prev- alence ratio: 3.46, 95 % CI: 1.68 - 7.14) times more likely to be non-adherent. Conclusion: One in 10 MDR-TB patients treated at Mulago hospital is non-adherent to treatment. History of previous DR- TB treatment was significantly associated with non-adherence in this study. MDR-TB program should strengthen adherence counselling, strengthen DST surveillance, and close monitoring for previously treated DR-TB patients. Keywords: Non-adherence; multi-drug resistant tuberculosis; treatment.

scholarly journals Prevalence and factors associated with non-adherence to multi-drug resistant tuberculosis (MDR-TB) treatment at Mulago National Referral Hospital, Kampala, Uganda

2021 ◽  
Vol 21 (1) ◽  
pp. 238-47
Author(s):  
Charles Batte ◽  
Martha S Namusobya ◽  
Racheal Kirabo ◽  
John Mukisa ◽  
Susan Adakun ◽  
...  
Keyword(s):  
Mulago Hospital ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Factors Associated ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
History Of ◽  
Previously Treated

Background: In Uganda, 12% of previously treated TB cases and 1.6% of new cases have MDR-TB and require specialized treatment and care. Adherence is crucial for improving MDR-TB treatment outcomes. There is paucity of information on the extent to which these patients adhere to treatment and what the drivers of non-adherence are. Methods: We conducted a cohort study using retrospectively collected routine program data for patients treated for MDR- TB between January 2012 – May 2016 at Mulago Hospital. We extracted anonymized data on non-adherence (missing 10% or more of DOT), socio-economic, demographic, and treatment characteristics of the patients. All participants were sen- sitive to MDR-TB drugs after second line Drug Susceptible Testing (DST) at entry into the study. Factors associated with non-adherence to MDR-TB treatment were determined using generalized linear models for the binomial family with log link and robust standard errors. We considered a p- value less than 0.05 as statistically significant. Results: The records of 227 MDR- TB patients met the inclusion criteria, 39.4% of whom were female, 32.6% aged be- tween 25 – 34 years, and 54.6% living with HIV/AIDS. About 11.9% of the patients were non-adherent. The main driver for non-adherence was history of previous DR-TB treatment; previously treated DR-TB patients were 3.46 (Adjusted prev- alence ratio: 3.46, 95 % CI: 1.68 - 7.14) times more likely to be non-adherent. Conclusion: One in 10 MDR-TB patients treated at Mulago hospital is non-adherent to treatment. History of previous DR- TB treatment was significantly associated with non-adherence in this study. MDR-TB program should strengthen adherence counselling, strengthen DST surveillance, and close monitoring for previously treated DR-TB patients. Keywords: Non-adherence; multi-drug resistant tuberculosis; treatment.

scholarly journals Prevalence and risk factors of multi-drug resistant tuberculosis in Dalian, China

2017 ◽  
Vol 45 (6) ◽  
pp. 1779-1786 ◽  
Author(s):  
Xin-Tong Lv ◽  
Xi-Wei Lu ◽  
Xiao-Yan Shi ◽  
Ling Zhou
Keyword(s):  
Risk Factors ◽  
Population History ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Previously Treated Patients ◽  
Previously Treated

Objectives To investigate the prevalence and risk factors associated with multi-drug resistant tuberculosis (MDR–TB) in Dalian, China. Methods This was a retrospective review of data from patients attending a TB clinic in Dalian, China between 2012 and 2015. Demographic and drug susceptibility data were retrieved from TB treatment cards. Univariate logistic analysis was used to assess the association between risk factors and MDR–TB. Results Among the 3552 patients who were smear positive for Mycobacterium tuberculosis (MTB), 2918 (82.2%) had positive MTB cultures and 1106 (31.1%) had isolates that showed resistance to at least one drug. The overall prevalence of MDR–TB was 10.1% (359/3552; 131/2261 [5.8%] newly diagnosed and 228/1291 [17.7%] previously treated patients). Importantly, 75 extensively drug-resistant TB isolates were detected from 25 newly treated and 50 previously treated patients. In total, 215 (6.1%) patients were infected with a poly-resistant strain of MTB. Previously treated patients and older patients were more likely to develop MDR–TB. Conclusions The study showed a high prevalence of MDR–TB among the study population. History of previous TB treatment and older age were associated with MDR–TB.

scholarly journals Risk factors associated with drug-resistant tuberculosis in Ethiopia: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Ayinalem Alemu ◽  
Zebenay Workneh Bitew ◽  
Getu Diriba ◽  
Balako Gumi
Keyword(s):  
Risk Factors ◽  
Meta Analysis ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Pulmonary Tb ◽  
Factors Associated ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
History Of

The emergence of drug-resistant tuberculosis (DR-TB) is becoming a challenge to the national TB control programs including Ethiopia. Different risk factors are associated with the emergence of DR-TB. Identifying these risk factors in a local setting is important to strengthen the effort to prevent and control DR-TB. Thus, this study aimed to assess the risk factors associated with drug-resistant TB in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist was followed to conduct this study. We systematically searched the articles from electronic databases and gray literature sources. We used the Joanna Briggs Institute Critical Appraisal tools to assess the quality of studies. Data were analyzed using STATA version 15. We estimated the pooled OR along with 95%CI for each risk factor. The heterogeneity of the studies was assessed using the forest plot and I heterogeneity test. Besides, we explored the presence of publication bias through visual inspection of the funnel plot and Egger’s regression test. After intense searching, we found 2238 articles, and 27 eligible studies were included in the final analysis. Based on the pooled analysis of the odds ratio, unemployment (OR; 2.71, 95% CI; 1.64, 3.78), having a history of the previous TB (OR; 4.83, 95% CI; 3.02, 6.64), having contact with a known TB patient (OR; 1.72, 95% CI; 1.05, 2.40), having contact with a known MDR-TB patient (OR; 2.54, 95% CI; 1.46, 3.63), and having pulmonary TB (OR; 1.80, 95% CI; 1.14, 2.45) were found to be the risk factors of drug-resistant TB. While older age TB patients (OR; 0.77, 95% CI; 0.60, 0.95) including age above 45 years OR; (0.76, 95% CI; 0.55, 0.97), and males (OR; 0.86, 95% CI; 0.76, 0.97) were found to had lower risk of DR-TB compared to their counterparts. A previous history of TB treatment is a major risk factor for acquiring DR-TB in Ethiopia that might be due to poor adherence during the first-line anti TB treatment. Besides, having contact with a known TB patient, having contact with a known MDR-TB patient, having pulmonary TB, and being unemployed were the risk factors of DR-TB in Ethiopia. Thus, active screening of TB contacts for DR-TB might help to detect DR-TB cases as early as possible and could help to mitigate its further transmission across the community.

scholarly journals Risk factors of Multidrug Resistant Tuberculosis in central Nepal: A pilot study

2012 ◽  
Vol 8 (4) ◽  
pp. 392-397 ◽  
Author(s):  
S B Marahatta ◽  
J Kaewkungwal ◽  
P Ramasoota ◽  
P Singhasivanon
Keyword(s):  
Risk Factors ◽  
Social Stigma ◽  
Smoking Habit ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
National Tuberculosis ◽  
Mdr Tb ◽  
History Of

Introduction Tuberculosis is the most widespread infectious disease in Nepal and poses a serious threat to the health and development of the country. Incidences of drug resistant tuberculosis in Nepal are increasing and this tuberculosisis a major threat to successfully controlling tuberculosis . Objective The general objective of the study was to assess the risk factors of multi-drug resistant tuberculosis among the patients attending the National Tuberculosis Centre, Bhaktpur Nepal. Methods An observational study/ case-control study with a Atotal number of 55 multi-drug resistant tuberculosis cases and 55 controls. The study was conducted among the patient attending in the National Tuberculosis Centre , Bhaktpur Nepal for six months, between May–October 2010. sImulti-drug resistant tuberculosis wasThe collected data was analysed in SPSS 11.5 version. The association between categorical variables were analysed by chi-square tests, OR and their 95% CI were measured. Results The total number of patients used for the study was 110, of which among them 55 were cases and 55 were controls . Our study revealed that there were significant associations between history of prior TB MDR-TB OR =2.799 (95 % CI 1.159 to 6.667) (p=0.020); smoking habit OR =2.350 and (95%CI 1.071 to 5.159) (p=0.032); social stigma social stigma OR 2.655 (95%CI r 1.071 to 5.159) (p=0.013); knowledge on MDR-TB OR =9.643 (95% CI 3.339 to 27.846) (p < 0.001)and knowledge on DOTS Plus OR=16.714 (95% CI is ranging from 4.656 to 60.008) (p< 0.001). However, there was no association found between alcohol drinking habits and ventilation in the room. Conclusion Our study revealed that there were significant associations between history of prior tuberculosis, smoking habit social stigma social stigma, knowledge on multi-drug resistant tuberculosis and knowledge on DOTS Plus with multi-drug resistant tuberculosis However there was no association between alcohol drinking habit and ventilation in room with multi-drug resistant tuberculosis. http://dx.doi.org/10.3126/kumj.v8i4.6238 Kathmandu Univ Med J 2010;8(4):392-7

scholarly journals Adverse Drug Reactions in Patients put on Multi Drug Resistant Tuberculosis (MDR-TB) Treatment in Seven Districts of Central Gujarat

2015 ◽  
Vol 7 (4s) ◽  
pp. 425-431 ◽  
Author(s):  
Sangita Vashrambhai Patel ◽  
Nimavat Kapil Bhikhubhai ◽  
Alpesh Bhimabhai patel ◽  
Kalpita Samrat Shringarpure ◽  
Kedar Gautambhai Mehta ◽  
...  
Keyword(s):  
Adverse Drug Reactions ◽  
Drug Resistant ◽  
Drug Reactions ◽  
Drug Resistant Tuberculosis ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

scholarly journals S2 Multi-drug Resistant Tuberculosis (MDR-TB) treatment in the UK: a survey of injectable use and toxicity in practice

Thorax ◽  
2010 ◽  
Vol 65 (Suppl 4) ◽  
pp. A4-A5
Author(s):  
A. Sturdy ◽  
A. Goodman ◽  
R. J. Jose ◽  
A. Loyse ◽  
M. O'Donoghue ◽  
...  
Keyword(s):  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
The Uk

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 Factors Associated with Multi-Drug Resistant Tuberculosis among TB Patients in Selected Treatment Centers of Amhara Region: A Case-Control Study

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Getahun Yeshiwas Ambaye ◽  
Gebiyaw Wudie Tsegaye
Keyword(s):  
Case Control Study ◽  
Previous History ◽  
Drug Resistant ◽  
Amhara Region ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
History Of ◽  
Control Study

BACKGROUND: Multi-drug Resistant Tuberculosis (MDR-TB) is found to be a major public health problem both in developed and developing countries. Ethiopia is one of the 30 high MDR-TB burden countries in the world. Although several studies were done to identify the determinants of MDR-TB, the reported findings are heterogeneous across the world.METHODS: Unmatched case-control study was conducted at Debre Markose Referral Hospital, Debre Birhan Referral Hospital, and Boru Media District Hospital in Amhara Region, Northern Ethiopia, from March 01/2019- April 30/2019. Cases were all tuberculosis patients with culture or line probe assay confirmed mycobacterium tuberculosis resistant to at least both Isoniazid and Rifampicin and registered on second-line TB treatment. Controls were all patients with Bacteriological (molecular) proven drug-susceptible TB strains and whose recent smears result were turned to negative and registered as cured from January 01/2014 – December 31/2018. A pre-tested checklist was used to collect the data.RESULT: Of the total reviewed documents (393), 98 cases and 295 controls were involved in this study. And, 54(55.1%) among cases and 162(54.9%) among controls were males. sixty nine(70.4%) among cases and 163(55.3) among controls were within the age group of 26-45 years. In the multivariable logistic regression analysis, age between 26-45years old (AOR=3.35; 95% CI: 1.15, 9.77), previous history of TB treatment (AOR= 14.2;95%CI: 7.8, 25.3) and being HIV positive (AOR=4.4; 95% CI:1.8, 10.4) were significantly associated with MDR-TB.CONCLUSION: Age between 26-45 years old, previously treated cases and TB/HIV co-infection were identified as the determinants of MDR-TB. Special attention should be given to age between 26-45 years old, previous history of TB treatment and TB/HIV co-infection to prevent and control MDR-TB in the local context.

scholarly journals Predicting the Outcomes of New Short-Course Regimens for Multi-Drug Resistant Tuberculosis Using Intrahost and Pharmacokinetic-Pharmacodynamic Modelling

2018 ◽  
Author(s):  
Tan N Doan ◽  
Pengxing Cao ◽  
Theophilus I Emeto ◽  
James M McCaw ◽  
Emma S McBryde
Keyword(s):  
Treatment Duration ◽  
Treatment Success ◽  
Empirical Evaluation ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Short Course ◽  
Mdr Tb

ABSTRACTShort-course regimens for multi-drug resistant tuberculosis (MDR-TB) are urgently needed. Limited data suggest that the new drug, bedaquiline (BDQ), may have the potential to shorten MDR-TB treatment to less than six months when used in conjunction with standard anti-TB drugs. However, the feasibility of BDQ in shortening MDR-TB treatment duration remains to be established. Mathematical modelling provides a platform to investigate different treatment regimens and predict their efficacy. We developed a mathematical model to capture the immune response to TB inside a human host environment. This model was then combined with a pharmacokinetic-pharmacodynamic model to simulate various short-course BDQ-containing regimens. Our modelling suggests that BDQ could reduce MDR-TB treatment duration to just 18 weeks (four months) while still maintaining a very high treatment success rate (100% for daily BDQ for two weeks, or 95% for daily BDQ for one week during the intensive phase). The estimated time to bacterial clearance of these regimens ranges from 27 to 33 days. Our findings provide the justification for empirical evaluation of short-course BDQ-containing regimens. If short-course BDQ-containing regimens are found to improve outcomes then we anticipate clear cost-savings and a subsequent improvement in the efficiency of national TB programs.

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