| Autor: |
Anh LTN; Vietnam Integrated Center for TB and Respirology Research, National Lung Hospital, Ha Noi 100000, Vietnam., M V Kumar A; International Union Against Tuberculosis and Lung Disease, South East Asia Office, New Delhi 110016, India.; International Union Against Tuberculosis and Lung Disease, 75006 Paris, France.; Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru 575018, India., Ramaswamy G; National Centre of Excellence and Advanced Research on Anemia Control, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110029, India., Htun T; International Union Against Tuberculosis and Lung Disease, Mandalay 05021, Myanmar., Thanh Hoang Thi T; Programmatic Management of Drug Resistant Tuberculosis Unit, National Lung Hospital, Ha Noi 100000, Vietnam., Hoai Nguyen G; Interactive Research and Development, Ho Chi Minh 700000, Vietnam., Quelapio M; KNCV Tuberculosis Foundation, 2596 BC The Hague, The Netherlands., Gebhard A; KNCV Tuberculosis Foundation, 2596 BC The Hague, The Netherlands., Nguyen HB; Vietnam Integrated Center for TB and Respirology Research, National Lung Hospital, Ha Noi 100000, Vietnam.; International Union Against Tuberculosis and Lung Disease, 75006 Paris, France., Nguyen NV; Vietnam Integrated Center for TB and Respirology Research, National Lung Hospital, Ha Noi 100000, Vietnam. |
| Abstrakt: |
Vietnam has been using a levofloxacin-based shorter treatment regimen (STR) for rifampicin resistant/multidrug-resistant tuberculosis (RR/MDR-TB) patients since 2016 on a pilot basis. This regimen lasts for 9-11 months and is provided to RR/MDR-TB patients without second-line drug resistance. We report the treatment outcomes and factors associated with unsuccessful outcomes. We conducted a cohort study involving secondary analysis of data extracted from electronic patient records maintained by the national TB program (NTP). Of the 302 patients enrolled from April 2016 to June 2018, 259 (85.8%) patients were successfully treated (246 cured and 13 'treatment completed'). Unsuccessful outcomes included: treatment failure (16, 5.3%), loss to follow-up (14, 4.6%) and death (13, 4.3%). HIV-positive TB patients, those aged ≥65 years and patients culture-positive at baseline had a higher risk of unsuccessful outcomes. In a sub-group of patients enrolled in 2016 (n = 99) and assessed at 12 months after treatment completion, no cases of relapse were identified. These findings vindicate the decision of the Vietnam NTP to use a levofloxacin-based STR in RR/MDR-TB patients without second-line drug resistance. This regimen may be considered for nationwide scale-up after a detailed assessment of adverse drug events. |
