Factors associated with treatment success and death in cases with multidrug-resistant tuberculosis in Bulgaria, 2009–2010

Milanov, Vladimir; Falzon, Dennis; Zamfirova, Mariya; Varleva, Tonka; Bachiyska, Elizabeta; Koleva, Antoniya; Dara, Masoud

doi:10.1016/j.ijmyco.2015.03.005

Cited by 23 publications

(15 citation statements)

References 8 publications

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“…Over 17% of study participants had unfavourable treatment outcomes (5% mortality and 12% lost-to-follow-up), similar to that reported by Meressa et al [44],. However, this is lower than that reported by Dheda et al, [46] and Milanov et al, [47] in South Africa and Bulgaria who both documented over 50% unfavourable treatment outcomes. Previous findings have argued that severe malnutrition (BMI < 16 kg/m2), HIV coinfection, previous history of anti-TB therapy and drug adverse events can predict poor treatment outcomes [47,48].…”

Section: Discussioncontrasting

confidence: 58%

“…However, this is lower than that reported by Dheda et al, [46] and Milanov et al, [47] in South Africa and Bulgaria who both documented over 50% unfavourable treatment outcomes. Previous findings have argued that severe malnutrition (BMI < 16 kg/m2), HIV coinfection, previous history of anti-TB therapy and drug adverse events can predict poor treatment outcomes [47,48]. In this study, 29.9% of the study participants had low BMI and 23% were infected with HIV but had no effects on MDR-TB treatment outcomes.…”

Section: Discussioncontrasting

confidence: 58%

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Whole genome sequencing of Mycobacterium tuberculosis isolates and clinical outcomes of patients treated for multidrug-resistant tuberculosis in Tanzania

Katale

Mbelele

Lema³

et al. 2020

BMC Genomics

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Background: Tuberculosis (TB), particularly multi-and or extensive drug resistant TB, is still a global medical emergency. Whole genome sequencing (WGS) is a current alternative to the WHO-approved probe-based methods for TB diagnosis and detection of drug resistance, genetic diversity and transmission dynamics of Mycobacterium tuberculosis complex (MTBC). This study compared WGS and clinical data in participants with TB.Results: This cohort study performed WGS on 87 from MTBC DNA isolates, 57 (66%) and 30 (34%) patients with drug resistant and susceptible TB, respectively. Drug resistance was determined by Xpert® MTB/RIF assay and phenotypic culture-based drug-susceptibility-testing (DST). WGS and bioinformatics data that predict phenotypic resistance to anti-TB drugs were compared with participant's clinical outcomes. They were 47 female participants (54%) and the median age was 35 years (IQR): 29-44). Twenty (23%) and 26 (30%) of participants had TB/HIV coinfection BMI < 18 kg/m 2 respectively. MDR-TB participants had MTBC with multiple mutant genes, compared to those with mono or polyresistant TB, and the majority belonged to lineage 3 Central Asian Strain (CAS). Also, MDR-TB was associated with delayed culture-conversion (median: IQR (83: 60-180 vs. 51:30-66) days). WGS had high concordance with both culture-based DST and Xpert® MTB/RIF assay in detecting drug resistance (kappa = 1.00). Conclusion: This study offers comparison of mutations detected by Xpert and WGS with phenotypic DST of M. tuberculosis isolates in Tanzania. The high concordance between the different methods and further insights provided by WGS such as PZA-DST, which is not routinely performed in most resource-limited-settings, provides an avenue for inclusion of WGS into diagnostic matrix of TB including drug-resistant TB.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussioncontrasting

confidence: 58%

Whole genome sequencing of Mycobacterium tuberculosis isolates and clinical outcomes of patients treated for multidrug-resistant tuberculosis in Tanzania

Katale

Mbelele

Lema³

et al. 2020

BMC Genomics

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“…A study in Lithuania reported that smear-positivity at diagnosis was associated with about 1.5 times increase in the risk of death among MDR-TB patients [16]. Furthermore, smear positivity at diagnosis was also associated with a five-fold increase in the risk of death among MDR-TB patients in a recent study in Bulgaria [17]. The influence of smear positivity at diagnosis on the survival of MDR-TB patients reported in this study is consistent with the findings of previous studies.…”

Section: Discussionmentioning

confidence: 95%

Survival of smear-positive multidrug resistant tuberculosis patients in Witbank, South Africa: A retrospective cohort study

Olaleye

Beke

2016

Infectious Diseases

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“…Hasil penelitian ini tedapat perbedaan dengan hasil penelitian sebelumnya yang menunjukkan adanya hubungan signifikan antara jenis kelamin dan hasil pengobatan. 10,11 Perbedaan hasil penelitian ini dengan penelitian sebelumnya bisa terjadi karena adanya perbedaan metode penelitian yang digunakan, jumlah sampel yang digunakan, lokasi penelitian, dan karakteristik sampel. Hubungan antara jenis kelamin dan hasil pengobatan sulit untuk dinilai karena bersifat k ompleks.…”

Section: Factors Associated With Recovery Success After Short Treatmeunclassified

Faktor-Faktor yang Berhubungan Dengan Hasil Pengobatan Regimen Pendek (Short Treatment Regiment) pada Pasien Tuberkulosis Resistensi Obat di Indonesia Tahun 2017

Agustina

Maulida

Yovsyah

2019

Jurnal Epidemiologi Kesehatan Indonesia

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TB RO menyebabkan beban pengendalian penyakit TB menjadi bertambah. Adanya penurunan angka keberhasilan pengobatan dari tahun 2010 sebesar 67,9% menjadi 51,1% di tahun 2013 dan peningkatan kasus pasien putus berobat mendorong Indonesia menerapkan pengobatan jangka pendek untuk meningkatkan angka keberhasilan pengobatan TB RO dan menurunkan kasus pasien putus berobat. Penelitian ini bertujuan untuk melihat status kesuksesan kesembuhan dari pengobatan TB RO dan faktor-faktor yang berhubungan dengan status kesuksesan kesembuhan dari pengobatan regimen pendek di Indonesia tahun 2017 dengan menggunakan data pasien TB RO yang tercatat dalam e-TB manager dari pasien-pasien berusia ≥ 15 tahun yang telah ada status hasil pengobatan regimen pendek maksimal pada bulan November 2018 dengan desain penelitian kohort retrospektif. Didapatkan 223 kasus dengan 104 (46,6%) pengobatan sukses dan sisanya yaitu 119 (53,4%) pengobatan tidak sukses. Hasil analisis bivariat dengan chi-square menunjukkan beberapa factor yang berhubungan dengan status kesuksesan kesembuhan dari pengobatan regimen pendek. Faktor-faktor ini ialah usia (crude RR 2,09, 95% CI 1,19–3,65), resistensi ofloksasin (crude RR 7,73, 95% CI 0,92–64,28) dan resistensi kanamisin (crude RR 0,47, 95% CI 0,39–0,57) memiliki hubungan yang signifikan secara statistik dengan kesuksesan kesembuhan dari pengobatan regimen pendek. Berdasarkan hasil penelitian ini, penderita TB RO dengan usia 45 tahun ke atas agar mendapatkan perhatian lebih dalam pengobatan regimen pendek ini karena berpeluang lebih rendah untuk mendapatkan status pengobatan yang sukses. Ketepatan data pada e-TB manager pun perlu dilihat kembali karena pada penelitian ini agar penelitian selanjutnya mendapatkan hasil yang akurat.

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Factors associated with treatment success and death in cases with multidrug-resistant tuberculosis in Bulgaria, 2009–2010

Abstract: Most MDR-TB patients in this first treatment cohort using WHO-recommended norms had advanced disease explaining the high mortality and low success. Early, adequate treatment of MDR-TB patients can improve outcomes and avert transmission.

Cited by 23 publications

References 8 publications

Whole genome sequencing of Mycobacterium tuberculosis isolates and clinical outcomes of patients treated for multidrug-resistant tuberculosis in Tanzania

Whole genome sequencing of Mycobacterium tuberculosis isolates and clinical outcomes of patients treated for multidrug-resistant tuberculosis in Tanzania

Survival of smear-positive multidrug resistant tuberculosis patients in Witbank, South Africa: A retrospective cohort study

Faktor-Faktor yang Berhubungan Dengan Hasil Pengobatan Regimen Pendek (Short Treatment Regiment) pada Pasien Tuberkulosis Resistensi Obat di Indonesia Tahun 2017

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