Factors predicting treatment success in multi-drug resistant tuberculosis patients treated under programmatic conditions

Janmeja, Ashok Kumar; Aggarwal, Deepak; Dhillon, Ruchika

doi:10.1016/j.ijtb.2017.12.015

Cited by 15 publications

(17 citation statements)

References 13 publications

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“…[ 30 , 31 ] Our study reaffirms a previous study that showed Hangzhou as having a higher MDR-TB treatment success rate (73.7%) than other areas of China. [ 22 ] This study's success rate is higher than rates seen in most resource-limited countries [ 15 , 32 – 34 ] but lower than success rates of resource-rich counties. [ 11 , 35 , 36 ] When compared to cure rates from other countries, we should note that the successful treatment rate in our study included both cure and completion of treatment according to Chinese guidelines; the successful treatment rate (75.6%) was slightly higher than the cure rate (71.4%).…”

Section: Discussionmentioning

confidence: 96%

Treatment outcomes of multidrug-resistant tuberculosis in Hangzhou, China, 2011 to 2015

Shi

Lü

et al. 2020

Medicine

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Treatment of multidrug-resistant tuberculosis (MDR-TB) is challenging. More research is needed to understand treatment outcomes and associated factors. A retrospective cohort study was conducted to assess trends and predictors of treatment success among 398 MDR-TB and extensively drug resistant TB patients who started treatment in 2011 to 2015 in Hangzhou, China. Sociodemographic and clinical characteristic data were obtained from the national reporting database. Chi-square test for trend was used to evaluate changes in treatment success rates over the study years, and Cox regression analysis was used to identify predictors for poor treatment outcomes. The treatment success rate was 76% (301/398) for all participants, 77% (298/387) for MDR-TB cases and 27% (3/11) for extensively drug-resistant tuberculosis -TB cases. Treatment success increased significantly from 66% among patients who started treatment in 2011 to 85% in 2015 ( P < .01). Of the 97 (24.4%) patients with unsuccessful treatment outcomes, 10 (2.5%) died, 64 (16.1%) failed treatment, and 23 (5.8%) were lost to follow-up. Patients who started treatment in 2013 to 2015 were less likely to have unsuccessful outcomes than those who started in 2011–2012 (adjusted odds ratio [AOR] 0.4, 95% confidence interval [CI] 0.3–0.6), patients ≥25 years were more likely to have unsuccessful outcomes than younger patients (AOR 1.6, 95% CI 1.3–2.1), and cases with kanamycin resistance was associated with three times the odds of having unsuccessful outcomes than kanamycin-susceptible cases (AOR 3.0, 95% CI 1.5–5.8). With proper case management of MDR-TB, patients can achieve a high treatment success rate. Hangzhou's program offers clinical evidence that can be used to inform MDR-TB programs elsewhere in China and abroad.

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Section: Discussionmentioning

confidence: 96%

Treatment outcomes of multidrug-resistant tuberculosis in Hangzhou, China, 2011 to 2015

Shi

Lü

et al. 2020

Medicine

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“…There were 30 patients with no sputum data conversion in the unsuccessful group due to LTFU in the first three months of treatment. Regarding history of previous TB treatment, 47.3% were relapse cases, followed by failure cases (24.7%), LTFU (14.0%) and new TB patient (14.0%). Overall, the proportion of successful outcomes was higher than unsuccessful (64.5% vs. 35.5%).…”

Section: Baseline Characteristicsmentioning

confidence: 99%

“…Malnutrition may also result in secondary immunodeficiency that increases the risk of other infections [44]. Several studies showed that undernutrition is one of the contributing factors for poor outcomes in MDR-TB treatment [45][46][47]. Several studies also showed weight gain during treatment as an indicator of successful outcome [48,49].…”

Section: Plos Onementioning

confidence: 99%

Factors associated with treatment outcome of MDR/RR-TB patients treated with shorter injectable based regimen in West Java Indonesia

et al. 2022

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Background and aims Multi drug or rifampicin resistant tuberculosis (MDR/RR-TB) is a major burden to TB prevention and eradication globally. Since 2016, WHO guidelines have included options for treating MDR/RR-TB with a standard regimen of 9 to 11 months duration (the ’shorter regimen’) rather than an individual regimen of at least 20 months. This regimen has been introduced in Indonesia since September 2017. Therefore, we aimed to determine the success rate and factors associated with the treatment outcome of shorter injectable based regimen in West Java province, Indonesia. Methods This was a retrospective cohort study of MDR/RR-TB patients aged over 18 years old who received the shorter injectable based regimen between September 2017 and December 2020. We defined successful outcomes as the combined proportion of patients who were cured or had complete treatment. While, unsuccessful outcomes were defined as the combined proportion of patients who died from any causes, failure, and loss to follow-up (LTFU). Results A total of 315 patients were included in this study. The success rate was 64.5%. Multivariate analysis showed male gender (aRR = 1.18, 95% CI 1.04 to 1.34) increased the chance of successful outcome, while malnutrition (aRR = 0.78, 95% CI 0.68 to 0.89), history of previous TB treatment (aRR = 0.80%CI 0.68 to 0.94), and time of culture conversion >2 months (aRR = 0.72 (95% CI 0.59 to 0.87) decreased the chance of successful outcome. Conclusion History of previous TB treatment, time of culture conversion >2 months, and malnutrition were independent factors that decrease the chance for success rate, while male gender increase the likelihood for success rate of patients treated by the shorter injectable based regimen.

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“…They have suggested that nutritional interventions rather than DOTS plus strategy is helpful in the improvement of success rate. The albumin levels were not significantly low in the study population as documented in the other studies probably because the patients were out patients and the pathogenesis of the disease would be less severe compared to in patients as evaluated in other studies [13] . Muthuraj et al conducted a study in patients with PTB along with HIV infection and has substantiated the importance of nutritional supplementation in such active TB cases in addition to Anti-Retroviral Therapy.…”

Section: Discussionmentioning

confidence: 50%

“…In 2018 a study done by Lee et al in Republic of Korea showed that TB unrelated death was commonly seen in old aged patients having low albumin levels [12] . In 2018, Janmeja et al has documented that BMI and albumin levels are reliable factor for prognosis in TB [13] . In 2017, Christina Yoon et al concluded that DILI would decrease the production of albumin in patients undergoing antituberculosis therapy [14] .…”

Section: Serum Albumin Levels In Tuberculosismentioning

confidence: 99%

Prevalence of hypoalbuminemia among tuberculosis patients receiving anti tuberculosis therapy: A cross sectional study

Ganesan¹,

Gopinath²

2019

Int. J. Adv. Biochem. Res.

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Background: Tuberculosis (TB) is one of the most common disease seen in overcrowding population. The high prevalence of tuberculosis in developing countries is due to various factors like poverty, malnutrition, overcrowding and poor socioeconomic status. It is having also been recorded that malnutrition is one of the major causes for the incidence of this disease in healthy individuals. Malnutrition can lead to poor prognosis of the Anti-tuberculosis therapy (ATT). Hence, Prevalence of hypoalbuminemia is of major concern in determining the prognosis of the disease. Objective: To estimate the serum total protein, albumin and globulin of patients with TB and compare albumin levels with Pulmonary Tuberculosis (PTB) patients and Extra Pulmonary Tuberculosis (EPTB) patients. Also, to correlate albumin levels with Body Mass Index (BMI) and Waist Hip Ratio (WHR) of the patients. Method: This cross-sectional study was conducted in 100 patients in two groups namely PTB and EPTB. The albumin levels were noted along with the BMI and WHR of the patients in both groups of TB. Results: The average age of the patients was 38.9 years. There was 65% of patients with PTB and 35% of patients with EPTB. The mean albumin, BMI and WHR of the patients were 3.2 ± 0.6, 19.7 ± 3.7 and 0.96 ± 0.01 respectively. The albumin levels of PTB group was 3.1 ± 0.6 and EPTB was 3.4 ± 0.6. the WHR of PTB patients was 0.99 ± 0.12 and EPTB was 0.90 ± 0.15. Albumin and WHR showed statistical significance with p value 0.007 and 0.003 respectively. Conclusion:Hypoalbuminemia in TB patients correlated with the BMI and with WHR. Sputum positivity was independent of the albumin levels. The results highlighted the prevalence of low albumin levels and malnutrition in patients with TB, especially PTB.

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Factors predicting treatment success in multi-drug resistant tuberculosis patients treated under programmatic conditions

Cited by 15 publications

References 13 publications

Treatment outcomes of multidrug-resistant tuberculosis in Hangzhou, China, 2011 to 2015

Treatment outcomes of multidrug-resistant tuberculosis in Hangzhou, China, 2011 to 2015

Factors associated with treatment outcome of MDR/RR-TB patients treated with shorter injectable based regimen in West Java Indonesia

Prevalence of hypoalbuminemia among tuberculosis patients receiving anti tuberculosis therapy: A cross sectional study

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