Treatment outcomes of multidrug-resistant tuberculosis patients in Gauteng, South Africa
| Autor: | Charmaine K. Mlambo, Nalin Rastogi, R. W. Warren, Thierry Zozio, Else Marais, Adriano Duse, James J. Lewis, Tommie C. Victor, Martin P. Grobusch |
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| Přispěvatelé: | AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Infectious diseases |
| Rok vydání: | 2013 |
| Předmět: |
Microbiology (medical)
Adult Male medicine.medical_specialty Tuberculosis Referral Adolescent Genotype Treatment outcome Antitubercular Agents Treatment failure 03 medical and health sciences South Africa Young Adult 0302 clinical medicine Risk Factors Tuberculosis Multidrug-Resistant medicine Humans 030212 general & internal medicine Treatment Failure Young adult Intensive care medicine Retrospective Studies High rate 0303 health sciences 030306 microbiology business.industry Retrospective cohort study General Medicine Mycobacterium tuberculosis medicine.disease 3. Good health Surgery Multiple drug resistance Infectious Diseases Treatment Outcome Female business |
| Zdroj: | Infection, 42(2), 405-413. Urban und Vogel |
| ISSN: | 1439-0973 0300-8126 |
| Popis: | Multidrug-resistant tuberculosis (MDR-TB) is associated with lengthy treatment, expensive and potentially toxic regimens, and high rates of treatment failure and death. This study describes the outcomes of 351 MDR-TB patients who started treatment between 2004 and 2007 at the provincial MDR-TB referral hospital in Johannesburg, South Africa, and investigates risk factors associated with death. The study involved the assessment of factors associated with treatment outcomes using a retrospective review of patient records, drug-susceptibility data and spoligotyping of isolates. Treatment success (completion/cure) was recorded in 158 (48.8 %) patients, while 65 (20 %) died, 93 (28.7 %) defaulted, 8 (2.5 %) failed treatment, 11(3.1 %) were transferred out to other health facilities and 16 (4.6 %) had no recorded final outcome. The proportion of successful treatment increased significantly over time. Univariable and multivariable analysis (P = 0.05) identified the year of MDR-TB diagnosis and spoligotype-defined families as factors associated with treatment outcome. No associations were found between treatment outcome and human immunodeficiency virus (HIV) status, previous TB and additional MDR resistance to streptomycin or ethambutol. Molecular typing of the strains revealed a diverse group of spoligotypes, with Beijing, LAM4 and H3 making up the largest groups. This is the first published study to investigate treatment outcomes at this facility and to find a link between genotype and treatment outcome, suggesting that genotype determination could potentially serve as a prognostic factor |
| Databáze: | OpenAIRE |
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