Elena Zhdanova1, Olga Goncharova2, Hayk Davtyan3, Sevak Alaverdyan3, Aelita Sargsyan3, Anthony D Harries4, Bolot Maykanaev2. 1. National Center of Phthisiology, Ministry of Health, Bishkek, Kyrgyz Republic. elenazhdanova201@gmail.com. 2. National Center of Phthisiology, Ministry of Health, Bishkek, Kyrgyz Republic. 3. Tuberculosis Research and Prevention Center, Yerevan, Armenia. 4. International Union against Tuberculosis and Lung Disease, Paris, France.
Abstract
INTRODUCTION: MDR/RR-TB is a growing problem in Kyrgyzstan. In 2005, the country introduced standard or individualized treatment for 20-24 months. Because of poor treatment outcomes, in 2017 a short treatment with strict eligibility criteria was introduced. The aim of this study was to compare characteristics and treatment outcomes of MDR/RR-TB patients receiving short (9-12 months) treatment in 2017 with those receiving standard or individualized (20-24 months) treatment in 2016/2017. METHODOLOGY: A comparative cohort study using routine programmatic data. Characteristics, sputum culture conversion and treatment outcomes were compared between those on short treatment with those on standard/individualized treatment using the chi-square test, crude and adjusted risk ratios (RR and aRR). RESULTS: The study included 274, 82 and 132 patients on standard, individualized and short treatment, respectively. There were more females, fewer migrants/homeless and unemployed and more new TB patients on short treatment compared with the other two groups. A favorable outcome (cure and treatment completed) was significantly higher in short treatment patients (83%) compared with those on standard (50%) or individualized (59%) treatment (p < 0.001). There was higher 1-month sputum culture conversion with short treatment (35%) compared with the other two groups (19% and 24%, p < 0.05). Short treatment (aRR 1.6, 1.4-1.8), female gender (aRR 1.2, 1.1-1.4), not being homeless (aRR 12.9, 4.5-17.3) and having new TB (aRR 1.3, 1.0-1.5) were independently associated with a favorable outcome. CONCLUSIONS: The treatment success was higher in selected MDR-TB patients given short treatment in Kyrgyzstan: this regimen should be scaled-up to all MDR-TB patients. Copyright (c) 2021 Elena Zhdanova, Olga Goncharova, Hayk Davtyan, Sevak Alaverdyan, Aelita Sargsyan, Anthony D Harries, Bolot Maykanaev.
INTRODUCTION: MDR/RR-TB is a growing problem in Kyrgyzstan. In 2005, the country introduced standard or individualized treatment for 20-24 months. Because of poor treatment outcomes, in 2017 a short treatment with strict eligibility criteria was introduced. The aim of this study was to compare characteristics and treatment outcomes of MDR/RR-TB patients receiving short (9-12 months) treatment in 2017 with those receiving standard or individualized (20-24 months) treatment in 2016/2017. METHODOLOGY: A comparative cohort study using routine programmatic data. Characteristics, sputum culture conversion and treatment outcomes were compared between those on short treatment with those on standard/individualized treatment using the chi-square test, crude and adjusted risk ratios (RR and aRR). RESULTS: The study included 274, 82 and 132 patients on standard, individualized and short treatment, respectively. There were more females, fewer migrants/homeless and unemployed and more new TB patients on short treatment compared with the other two groups. A favorable outcome (cure and treatment completed) was significantly higher in short treatment patients (83%) compared with those on standard (50%) or individualized (59%) treatment (p < 0.001). There was higher 1-month sputum culture conversion with short treatment (35%) compared with the other two groups (19% and 24%, p < 0.05). Short treatment (aRR 1.6, 1.4-1.8), female gender (aRR 1.2, 1.1-1.4), not being homeless (aRR 12.9, 4.5-17.3) and having new TB (aRR 1.3, 1.0-1.5) were independently associated with a favorable outcome. CONCLUSIONS: The treatment success was higher in selected MDR-TB patients given short treatment in Kyrgyzstan: this regimen should be scaled-up to all MDR-TB patients. Copyright (c) 2021 Elena Zhdanova, Olga Goncharova, Hayk Davtyan, Sevak Alaverdyan, Aelita Sargsyan, Anthony D Harries, Bolot Maykanaev.
Entities:
Keywords:
MDR/RR-TB; SORT IT; short treatment; sputum culture conversion; standard or individualized treatment; treatment outcomes
Authors: Abdul Wahid; Abdul Ghafoor; Abdul Wali Khan; Yaser Mohammed Al-Worafi; Abdullah Latif; Nisar Ahmed Shahwani; Muhammad Atif; Fahad Saleem; Nafees Ahmad Journal: Front Pharmacol Date: 2022-09-06 Impact factor: 5.988