PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: K F Laserson; L E Thorpe; V Leimane; K Weyer; C D Mitnick; V Riekstina; E Zarovska; M L Rich; H S F Fraser; E Alarcón; J P Cegielski; M Grzemska; R Gupta; M Espinal Journal: Int J Tuberc Lung Dis Date: 2005-06 Impact factor: 2.373
Authors: Ben J Marais; Charmaine K Mlambo; Nalin Rastogi; Thierry Zozio; Adriano G Duse; Thomas C Victor; Else Marais; Robin M Warren Journal: J Clin Microbiol Date: 2013-04-03 Impact factor: 5.948
Authors: N R Gandhi; J R Andrews; J C M Brust; R Montreuil; D Weissman; M Heo; A P Moll; G H Friedland; N S Shah Journal: Int J Tuberc Lung Dis Date: 2012-01 Impact factor: 2.373
Authors: Maryline Bonnet; Manuela Pardini; Francesca Meacci; Germano Orrù; Hasan Yesilkaya; Thierry Jarosz; Peter W Andrew; Mike Barer; Francesco Checchi; Heinz Rinder; Graziella Orefici; Sabine Rüsch-Gerdes; Lanfranco Fattorini; Marco Rinaldo Oggioni; Juliet Melzer; Stefan Niemann; Francis Varaine Journal: PLoS One Date: 2011-08-23 Impact factor: 3.240
Authors: Jason E Farley; Malathi Ram; William Pan; Stacie Waldman; Gail H Cassell; Richard E Chaisson; Karin Weyer; Joey Lancaster; Martie Van der Walt Journal: PLoS One Date: 2011-07-22 Impact factor: 3.240
Authors: Bourahima Kone; Anou M Somboro; Jane L Holl; Bocar Baya; Antieme Acg Togo; Yeya Dit Sadio Sarro; Bassirou Diarra; Ousmane Kodio; Robert L Murphy; William Bishai; Mamoudou Maiga; Seydou Doumbia Journal: Int J Mol Epidemiol Genet Date: 2020-06-15
Authors: B K Moore; E Anyalechi; M van der Walt; S Smith; L Erasmus; J Lancaster; S Morris; N Ndjeka; J Ershova; N Ismail; D Burton; H Menzies Journal: Int J Tuberc Lung Dis Date: 2015-06 Impact factor: 2.373
Authors: Platon Eliseev; Grigory Balantcev; Elena Nikishova; Anastasia Gaida; Elena Bogdanova; Donald Enarson; Tara Ornstein; Anne Detjen; Russell Dacombe; Elena Gospodarevskaya; Patrick P J Phillips; Gillian Mann; Stephen Bertel Squire; Andrei Mariandyshev Journal: PLoS One Date: 2016-04-07 Impact factor: 3.240
Authors: Joel Philip Samuels; Aashna Sood; Jonathon R Campbell; Faiz Ahmad Khan; James Cameron Johnston Journal: Sci Rep Date: 2018-03-21 Impact factor: 4.379