SETTING: Kathmandu Valley urban area, Nepal. OBJECTIVE: To study the probabilities of failure and relapse and of amplifying drug resistance to isoniazid (INH) and rifampicin (RMP) after the Category II retreatment regimen. DESIGN: Cohort study of smear-positive tuberculosis (TB) retreatment cases. RESULTS: Of 250 cases started on Category II retreatment, 209 were relapse cases; of these, 18 were INH-resistant RMP-susceptible, 18 were INH+RMP-resistant and nine were culture-negative. Of 19 return after interruption cases, two were INH-resistant RMP-susceptible and one was INH+RMP-resistant. Among 22 failures, no case was INH-resistant RMP-susceptible, six were INH+RMP-resistant and 14 were culture-negative. No INH-susceptible RMP-resistant cases were observed. Among 182 INH+RMP-susceptible cases, one failed and four relapsed during follow-up. Two of the five cases became INH+RMP-resistant and the remaining three remained susceptible. Among 20 INH-resistant RMP-susceptible cases, two failed and none relapsed. One of the two became INH+RMP-resistant and the other case remained INH-resistant RMP-susceptible. DISCUSSION: The proportion of resistance among retreatment cases in Kathmandu Valley was not high. The risk of relapse with amplification of RMP resistance among INH-resistant RMP-susceptible cases on the Category II retreatment regimen was 5% (1/20), and that among INH+RMP-susceptible cases was 1% (2/182).
SETTING: Kathmandu Valley urban area, Nepal. OBJECTIVE: To study the probabilities of failure and relapse and of amplifying drug resistance to isoniazid (INH) and rifampicin (RMP) after the Category II retreatment regimen. DESIGN: Cohort study of smear-positive tuberculosis (TB) retreatment cases. RESULTS: Of 250 cases started on Category II retreatment, 209 were relapse cases; of these, 18 were INH-resistant RMP-susceptible, 18 were INH+RMP-resistant and nine were culture-negative. Of 19 return after interruption cases, two were INH-resistant RMP-susceptible and one was INH+RMP-resistant. Among 22 failures, no case was INH-resistant RMP-susceptible, six were INH+RMP-resistant and 14 were culture-negative. No INH-susceptible RMP-resistant cases were observed. Among 182 INH+RMP-susceptible cases, one failed and four relapsed during follow-up. Two of the five cases became INH+RMP-resistant and the remaining three remained susceptible. Among 20 INH-resistant RMP-susceptible cases, two failed and none relapsed. One of the two became INH+RMP-resistant and the other case remained INH-resistant RMP-susceptible. DISCUSSION: The proportion of resistance among retreatment cases in Kathmandu Valley was not high. The risk of relapse with amplification of RMP resistance among INH-resistant RMP-susceptible cases on the Category II retreatment regimen was 5% (1/20), and that among INH+RMP-susceptible cases was 1% (2/182).
Authors: A Nakanwagi-Mukwaya; A J Reid; P I Fujiwara; F Mugabe; R J Kosgei; K Tayler-Smith; W Kizito; M Joloba Journal: Public Health Action Date: 2013-06-21
Authors: Federica Fregonese; Shama D Ahuja; Onno W Akkerman; Denise Arakaki-Sanchez; Irene Ayakaka; Parvaneh Baghaei; Didi Bang; Mayara Bastos; Andrea Benedetti; Maryline Bonnet; Adithya Cattamanchi; Peter Cegielski; Jung-Yien Chien; Helen Cox; Martin Dedicoat; Connie Erkens; Patricio Escalante; Dennis Falzon; Anthony J Garcia-Prats; Medea Gegia; Stephen H Gillespie; Judith R Glynn; Stefan Goldberg; David Griffith; Karen R Jacobson; James C Johnston; Edward C Jones-López; Awal Khan; Won-Jung Koh; Afranio Kritski; Zhi Yi Lan; Jae Ho Lee; Pei Zhi Li; Ethel L Maciel; Rafael Mello Galliez; Corinne S C Merle; Melinda Munang; Gopalan Narendran; Viet Nhung Nguyen; Andrew Nunn; Akihiro Ohkado; Jong Sun Park; Patrick P J Phillips; Chinnaiyan Ponnuraja; Randall Reves; Kamila Romanowski; Kwonjune Seung; H Simon Schaaf; Alena Skrahina; Dick van Soolingen; Payam Tabarsi; Anete Trajman; Lisa Trieu; Velayutham V Banurekha; Piret Viiklepp; Jann-Yuan Wang; Takashi Yoshiyama; Dick Menzies Journal: Lancet Respir Med Date: 2018-04 Impact factor: 102.642