Better programmatic outcome with the shorter regimen for the treatment of multidrug-resistant tuberculosis (MDR-TB) in Guinea: A retrospective cohort study

Autor: Gba-Foromo Cherif, Adama Marie Bangoura, Souleymane Camara, Lansana Mady Camara, Nimer Ortuno-Gutierrez, Tom Decroo, Boubacar Djelo Diallo, Lutgarde Lynen, Souleymane Hassane-Harouna, Diao Cisse
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Bacterial Diseases
RNA viruses
Time Factors
Antitubercular Agents
Pathology and Laboratory Medicine
Chi Square Tests
Cohort Studies
Geographical Locations
Medical Conditions
Mathematical and Statistical Techniques
0302 clinical medicine
Immunodeficiency Viruses
Tuberculosis
Multidrug-Resistant
Medicine and Health Sciences
030212 general & internal medicine
Child
Multidisciplinary
Pharmaceutics
Multi-Drug-Resistant Tuberculosis
Multi-drug-resistant tuberculosis
Statistics
Middle Aged
Treatment Outcome
Infectious Diseases
Medical Microbiology
Research Design
Child
Preschool
Viral Pathogens
Viruses
Physical Sciences
Tuberculosis Diagnosis and Management
Medicine
Female
Pathogens
Research Article
Cohort study
Adult
medicine.medical_specialty
Tuberculosis
Adolescent
Science
Context (language use)
Research and Analysis Methods
Microbiology
Young Adult
03 medical and health sciences
Pharmacotherapy
Drug Therapy
Diagnostic Medicine
Internal medicine
Retroviruses
medicine
Humans
Statistical Methods
Lost to follow-up
Microbial Pathogens
Statistical Hypothesis Testing
Retrospective Studies
business.industry
Lentivirus
Infant
Newborn
Organisms
Infant
Biology and Life Sciences
HIV
Retrospective cohort study
Tropical Diseases
medicine.disease
Regimen
030228 respiratory system
People and Places
Africa
Guinea
business
Mathematics
Zdroj: PLoS ONE, Vol 15, Iss 8, p e0237355 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: Setting Since August 2016, after the Ebola outbreak, the Guinean National Tuberculosis Programme and Damien Foundation implemented the shorter treatment regimen (STR) for multidrug-resistant tuberculosis (MDR-TB) in the three MDR-TB sites of Conakry. Previously, the longer regimen was used to treat MDR-TB. Objectives In a post-Ebola context, with a weakened health system, we describe the MDR-TB treatment uptake, patients characteristics, treatment outcomes and estimate the effect of using the longer versus STR on having a programmatically adverse outcome. Design This is a retrospective cohort study in RR-TB patients treated with either the longer regimen or STR. Results In Conakry, in 2016 and 2017, 131 and 219 patients were diagnosed with rifampicin-resistant tuberculosis (RR-TB); and 108 and 163 started treatment, respectively. Of 271 patients who started treatment, 75 were treated with the longer regimen and 196 with the STR. Patients characteristics were similar regardless of the regimen except that the median age was higher among those treated with a longer regimen (30 years (IQR:24–38) versus 26 years (IQR:21–39) for the STR. Patients treated with a STR were more likely to obtain a programmatically favorable outcome (74.0% vs 58.7%, p = 0.01) as lost to follow up was higher among those treated with a longer regimen (20.0% vs 8.2%, p = 0.006). Patients on a longer regimen were more than 2 times more likely (aOR: 2.5; 95%CI:1.3,4.7) to have a programmatically adverse outcome as well as being 45 years or older (aOR: 2.8; 95%CI:1.3,6.2), HIV positive (aOR:3.3; 95%CI:1.6,6.6) and attendance at a clinic without NGO support (aOR:3.0; 95%:1.6,5.7). Conclusion In Guinea, patients treated with the STR were more likely to have a successful outcome than those treated with the longer MDR-TB treatment regimen. Lost to follow-up was higher in patients on the longer regimen. However, STR treatment outcomes were less good than those reported in the region.
Databáze: OpenAIRE
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