M Makhmudova1, Z Maxsumova2, A Rajabzoda3, A Makhmadov1, S van den Hof4, V Mirtskhulava5. 1. KNCV Tuberculosis Foundation, Country Office, Dushanbe. 2. USAID TB Control Project, Dushanbe. 3. National Centre of Population Protection from Tuberculosis, Dushanbe, Tajikistan. 4. Technical Division, Team Evidence, KNCV Tuberculosis Foundation, The Hague, The Netherlands. 5. Technical Division, Team Evidence, KNCV Tuberculosis Foundation, The Hague, The Netherlands, Department of Public Health, Epidemiology, and Biostatistics, David Tvildiani Medical University, Tbilisi, Georgia.
Abstract
SETTING: Tajikistan is among the 30 countries with the highest multidrug-resistant tuberculosis (MDR-TB) burden. OBJECTIVE: To investigate the risk factors for unfavourable treatment outcomes among rifampicin-resistant (RR)/MDR-TB patients. DESIGN: Retrospective medical chart review of RR/MDR-TB patients enrolled for treatment in 2012-2013. RESULTS: Of 601 RR/MDR-TB patients, 58 (9.7%) had pre-extensively drug-resistant TB (pre-XDR-TB; i.e., MDR-TB with additional resistance to a fluoroquinolone or second-line injectable agent) and 45 (8%) had XDR-TB (MDR-TB with additional resistance to both). Treatment failure and death were reported in respectively 40 (7%) and 89 (15%) cases; 60 (10%) patients were lost to follow-up (LTFU). In multivariable analysis, treatment failure was associated with pre-XDR-TB (adjusted odds ratio [aOR] 3.67, 95%CI 1.47-9.18) or XDR-TB (aOR 8.61, 95%CI 3.48-21.34). Death was associated with age >45 years vs. <25 years (aOR 3.47, 95%CI 1.68-7.19) and no record of any adverse event during treatment (aOR 2.55, 95%CI 1.48-4.39). Changing place of residence during treatment was an independent predictor of LTFU (aOR 4.61, 95%CI 2.41-8.8). CONCLUSIONS: Our findings highlight the need for 1) the use of regimens with new anti-tuberculosis drugs; 2) good handover of TB patients and 3) effective tracing mechanisms if patients change a place of residence to prevent LTFU.
SETTING: Tajikistan is among the 30 countries with the highest multidrug-resistant tuberculosis (MDR-TB) burden. OBJECTIVE: To investigate the risk factors for unfavourable treatment outcomes among rifampicin-resistant (RR)/MDR-TB patients. DESIGN: Retrospective medical chart review of RR/MDR-TB patients enrolled for treatment in 2012-2013. RESULTS: Of 601 RR/MDR-TB patients, 58 (9.7%) had pre-extensively drug-resistant TB (pre-XDR-TB; i.e., MDR-TB with additional resistance to a fluoroquinolone or second-line injectable agent) and 45 (8%) had XDR-TB (MDR-TB with additional resistance to both). Treatment failure and death were reported in respectively 40 (7%) and 89 (15%) cases; 60 (10%) patients were lost to follow-up (LTFU). In multivariable analysis, treatment failure was associated with pre-XDR-TB (adjusted odds ratio [aOR] 3.67, 95%CI 1.47-9.18) or XDR-TB (aOR 8.61, 95%CI 3.48-21.34). Death was associated with age >45 years vs. <25 years (aOR 3.47, 95%CI 1.68-7.19) and no record of any adverse event during treatment (aOR 2.55, 95%CI 1.48-4.39). Changing place of residence during treatment was an independent predictor of LTFU (aOR 4.61, 95%CI 2.41-8.8). CONCLUSIONS: Our findings highlight the need for 1) the use of regimens with new anti-tuberculosis drugs; 2) good handover of TBpatients and 3) effective tracing mechanisms if patients change a place of residence to prevent LTFU.
Authors: Muhammad Abubakar; Nafees Ahmad; Abdul Ghafoor; Abdullah Latif; Izaz Ahmad; Muhammad Atif; Fahad Saleem; Shereen Khan; Amjad Khan; Amer Hayat Khan Journal: Front Pharmacol Date: 2021-03-31 Impact factor: 5.810
Authors: Farman Ullah Khan; Asim Ur Rehman; Faiz Ullah Khan; Khezar Hayat; Amjad Khan; Nafees Ahmad; Jie Chang; Usman Rashid Malik; Yu Fang Journal: Int J Environ Res Public Health Date: 2022-01-29 Impact factor: 3.390