Assessment of Effective Anti-TB Regimens and Adverse Outcomes Related Risk Factors in the Elderly and Senile-Aged TB Patients

Guo, Jun; Liu, Zhongda; Yang, Feng; Luo, Shui-Rong; Jing, Qi

doi:10.2147/idr.s414918

Cited by 5 publications

(1 citation statement)

References 18 publications

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“…Лікування пацієнтів похилого віку з ТБ порівняно з особами молодого віку має вищу частоту несприятливих результатів, і насамперед це низький рівень негативної конверсії мокротиння під час фази інтенсивної терапії [5]. А розвиток резистентності при використанні нестандартних схем лікування призводить до несприятливих наслідків і збільшує смертність, рівень якої серед людей похилого віку в 6 разів вищий, аніж серед молодих осіб [8].…”

Section: Effectiveness Of Usingunclassified

Effectiveness of using a long-term individualized treatment regimen of tuberculosis with multiple drug resistance in elderly people with concomitant diseases

Raznatovska,

Yasinskyi,

Shalmin

et al. 2023

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BACKGROUND. The actuality of the correct approach to the treatment of elderly patients with multidrug-resistance tuberculosis (MDR-TB) and concomitant diseases is unquestionable. We did not find in the available literature a study of the use of a completely oral long-term individualized treatment regimen (ITR) in this category of patients, which confirms the scientific novelty of the research. OBJECTIVE. To analyze the using of fully oral long-term ITR of MDR-TB in a 73-year-old patient with concomitant diseases on the example our own observation. MATERIALS AND METHODS. A clinical case of our own observation of a patient who was treated in the pulmonary TB department No. 2 of the Zaporizhzhia Regional Phthisiopulmonological Clinical Treatment and Diagnostic Center. RESULTS AND DISCUSSION. A 73-year-old man previously suffered from TB. He fell ill for the first time in 1987 and the first relapse of the specific process occurred in 2010. In both cases the patient received treatment of sensitive to antimycobacterial drugs TB, which ended with a positive outcome. During the relapse case described in the presented work, MDR-TB was diagnosed in the patient. Concomitant diseases of the cardiovascular system and the organ of vision were diagnosed in the patient. Before the ITR course completion the patient suffered a repeated myocardial infarction against the background of alcohol abuse. The patient received a completely oral long-term (18 month) course of MDR-TB ITR: 4 months of Lfx-Bdq-Cfz-Cs-Mpn-Amx/Clv, 2 months of Lfx-Bdq-Cfz-Cs, 12 months of Lfx-Cfz-Cs. Treatment was prescribed considering the data of the drug sensitivity test and the presence of contraindications to the appointment of Lzd. Complete cessation of bacterial excretion was registered after 4 months of antimycobacterial treatment. Tolerability of antimycobacterial therapy was satisfactory, adverse drugs’ reactions were not determined. CONCLUSIONS. The presented clinical case of our own observation demonstrates the high safety and effectiveness of a completely oral long-term (18 months) course of MDR-TB ITR in an elderly person with concomitant diseases, which is new data, since we did not find similar works in the available literature. The obtained data are an addition to the indications for use the all-oral long-term (18 months) course of ITR, including 4 months of Lfx-Bdq-Cfz-Cs-Mpn-Amx/Clv, 2 months of Lfx-Bdq-Cfz-Cs, 12 months of Lfx-Cfz-Cs in elderly patients with the simultaneous course of MDR-TB and concomitant cardiovascular and visual diseases.

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Section: Effectiveness Of Usingunclassified

Effectiveness of using a long-term individualized treatment regimen of tuberculosis with multiple drug resistance in elderly people with concomitant diseases

Raznatovska,

Yasinskyi,

Shalmin

et al. 2023

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Prevalence and patterns of drug-resistant Mycobacterium tuberculosis in newly diagnosed patients in China: A systematic review and meta-analysis

Jin,

Wu,

Chen

et al. 2024

Journal of Global Antimicrobial Resistance

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Epidemiological Characteristics and Spatiotemporal Clustering of Pulmonary Tuberculosis Among Students in Southwest China From 2016 to 2022: Analysis of Population-Based Surveillance Data

Kong,

Wu,

Cui

et al. 2024

JMIR Public Health Surveill

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Background Pulmonary tuberculosis (PTB), as a respiratory infectious disease, poses significant risks of covert transmission and dissemination. The high aggregation and close contact among students in Chinese schools exacerbate the transmission risk of PTB outbreaks. Objective This study investigated the epidemiological characteristics, geographic distribution, and spatiotemporal evolution of student PTB in Chongqing, Southwest China, aiming to delineate the incidence risks and clustering patterns of PTB among students. Methods PTB case data from students monitored and reported in the Tuberculosis Information Management System within the China Information System for Disease Control and Prevention were used for this study. Descriptive analyses were conducted to characterize the epidemiological features of student PTB. Spatial trend surface analysis, global and local spatial autocorrelation analyses, and disease rate mapping were performed using ArcGIS 10.3. SaTScan 9.6 software was used to identify spatiotemporal clusters of PTB cases. Results From 2016 to 2022, a total of 9920 student TB cases were reported in Chongqing, Southwest China, with an average incidence rate of 24.89/100,000. The incidence of student TB showed an initial increase followed by a decline, yet it remained relatively high. High school students (age: 13‐18 years; 6649/9920, 67.03%) and college students (age: ≥19 years; 2921/9920, 29.45%) accounted for the majority of student PTB cases. Patient identification primarily relied on passive detection, with a high proportion of delayed diagnosis and positive etiological results. COVID-19 prevention measures have had some impact on reducing incidence levels, but the primary factor appears to be the implementation of screening measures, which facilitated earlier case detection. Global spatial autocorrelation analysis indicated Moran I values of >0 for all years except 2018, ranging from 0.1908 to 0.4645 (all P values were <.05), suggesting strong positive spatial clustering of student PTB cases across Chongqing. Local spatial autocorrelation identified 7 high-high clusters, 13 low-low clusters, 5 high-low clusters, and 4 low-high clusters. High-high clusters were predominantly located in the southeast and northeast parts of Chongqing, consistent with spatial trend surface analysis and spatiotemporal clustering results. Spatiotemporal scan analysis revealed 4 statistically significant spatiotemporal clusters, with the most likely cluster in the southeast (relative risk [RR]=2.87, log likelihood ratio [LLR]=574.29, P<.001) and a secondary cluster in the northeast (RR=1.99, LLR=234.67, P<.001), indicating higher reported student TB cases and elevated risks of epidemic spread within these regions. Conclusions Future efforts should comprehensively enhance prevention and control measures in high-risk areas of PTB in Chongqing to mitigate the incidence risk among students. Additionally, implementing proactive screening strategies and enhancing screening measures are crucial for early identification of student patients to prevent PTB outbreaks in schools.

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Assessment of Effective Anti-TB Regimens and Adverse Outcomes Related Risk Factors in the Elderly and Senile-Aged TB Patients

Cited by 5 publications

References 18 publications

Effectiveness of using a long-term individualized treatment regimen of tuberculosis with multiple drug resistance in elderly people with concomitant diseases

Effectiveness of using a long-term individualized treatment regimen of tuberculosis with multiple drug resistance in elderly people with concomitant diseases

Prevalence and patterns of drug-resistant Mycobacterium tuberculosis in newly diagnosed patients in China: A systematic review and meta-analysis

Epidemiological Characteristics and Spatiotemporal Clustering of Pulmonary Tuberculosis Among Students in Southwest China From 2016 to 2022: Analysis of Population-Based Surveillance Data

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