Isoniazid mono-resistant tuberculosis: Time to take it seriously

Garg, Kranti; Saini, Varinder; Dhillon, Ruchika; Agarwal, Puneet

doi:10.1016/j.ijtb.2019.04.001

Cited by 11 publications

(5 citation statements)

References 19 publications

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“…It has strong early bactericidal activity and is long-term widely used. Numerous researchers believe resistance to isoniazid usually comes first during first-line chemotherapy regimens among new patients without HIV-infected in most settings (35)(36)(37). On the other hand, isoniazid resistance is even considered as the first step in development of MDR and extremely resistant (XDR) TB (38).…”

Section: Discussionmentioning

confidence: 99%

The impact of diabetes mellitus on drug resistance in patients with newly diagnosed tuberculosis: a systematic review and meta-analysis

Huang

Wang

et al. 2020

Ann Palliat Med

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tuberculosis reactivation, such as smoking, alcohol intake, poor living conditions, malnutrition, contacts with sputum smear positive patients, HIV, kidney dialysis, organ transplantation, etc. (3,4). On the other hand, lack of systems and tools to monitor and treat TB patients in some high-incidence countries and international migration flows might both increase the global TB incidence rate (5,6). Drug-resistant tuberculosis (DR-TB) has generated lots of

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Section: Discussionmentioning

confidence: 99%

The impact of diabetes mellitus on drug resistance in patients with newly diagnosed tuberculosis: a systematic review and meta-analysis

Huang

Wang

et al. 2020

Ann Palliat Med

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“…At this stage, 189 studies were excluded and the remaining 29 studies were screened by full text review. Finally, 25 studies were included in this study [4][5][6][7]. These studies were reported from five continents and from all the six WHO regions.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Studies conducted in different settings indicated that isoniazid mono-resistant TB is a problem in different countries [4][5][6][7][8]. The incidence of isoniazid mono-resistant TB is increasing and it is higher than RR-TB globally [9].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, studies revealed that those isoniazid mono-resistant TB cases had higher rate of poor treatment outcome compared to the drugsusceptible TB cases [10][11][12][13]. There are studies that assessed the treatment outcome of isoniazid mono-resistant TB cases [4][5][6][7], however, the findings are inconsistent. In addition, there is no comprehensive report at the global level.…”

Section: Introductionmentioning

confidence: 99%

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Poor treatment outcome and associated risk factors among patients with isoniazid mono-resistant tuberculosis: A systematic review and meta-analysis

et al. 2023

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Background To date, isoniazid mono-resistant tuberculosis (TB) is becoming an emerging global public health problem. It is associated with poor treatment outcome. Different studies have assessed the treatment outcome of isoniazid mono-resistant TB cases, however, the findings are inconsistent and there is limited global comprehensive report. Thus, this study aimed to assess the poor treatment outcome and its associated risk factors among patients with isoniazid mono-resistant TB. Methods Studies that reported the treatment outcomes and associated factors among isoniazid mono-resistant TB were searched from electronic databases and other sources. We used Joana Briggs Institute critical appraisal tool to assess the study’s quality. We assessed publication bias through visual inspection of the funnel plot and confirmed by Egger’s regression test. We used STATA version 17 for statistical analysis. Results Among 347 studies identified from the whole search, data were extracted from 25 studies reported from 47 countries. The pooled successful and poor treatment outcomes were 78% (95%CI; 74%-83%) and 22% (95%CI; 17%-26%), respectively. Specifically, complete, cure, treatment failure, mortality, loss to follow-up and relapse rates were 34%(95%CI; 17%-52%), 62% (95%CI; 50%-73%), 5% (95%CI; 3%-7%), 6% (95%CI; 4%-8%), 12% (95%CI; 8%-17%), and 1.7% (95%CI; 0.4%-3.1%), respectively. Higher prevalence of pooled poor treatment outcome was found in the South East Asian Region (estimate; 40%, 95%C; 34%-45%), and African Region (estimate; 33%, 95%CI; 24%-42%). Previous TB treatment (OR; 1.74, 95%CI; 1.15–2.33), having cancer (OR; 3.53, 95%CI; 1.43–5.62), and being initially smear positive (OR; 1.26, 95%CI; 1.08–1.43) were associated with poor treatment outcome. While those patients who took rifampicin in the continuation phase (OR; 0.22, 95%CI; 0.04–0.41), had extrapulmonary TB (OR; 0.70, 95%CI; 0.55–0.85), and took second-line injectable drugs (OR; 0.54, 95%CI; 0.33–0.75) had reduced risk of poor treatment outcome. Conclusion Isoniazid mono-resistant TB patients had high poor treatment outcome. Thus, determination of isoniazid resistance pattern for all bacteriologically confirmed TB cases is critical for successful treatment outcome. PROSPERO registration number: CRD42022372367

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“…Without knowing the isoniazid (INH) status, rifampicin-sensitive patients may be wrongly classified as drug-sensitive TB. Treating such erroneously classified drug-sensitive TB may lead to poor TB outcomes and the emergence of drug-resistant TB [ 2 ]. Isoniazid is bactericidal and an important first-line anti-TB drug.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Analysis of Clinico-Demographic and Genetic Characteristics and Treatment Outcomes in Isoniazid Mono-Resistant Tuberculosis Patients: A Single-Center Study

Hymn,

Gurjar,

Savani

2023

Cureus

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Introduction: Treatment failure and relapse rates are more likely to occur when there is isoniazid (INH) resistance. So, we can no longer ignore the problem of isoniazid mono-resistance. It is pertinent to control the spread of primary INH resistance and prevent secondary resistance. Aim: This study aims to evaluate subjects’ clinical, demographic, and genetic characteristics and explore their treatment outcomes. Methods: All data of isoniazid mono-resistant tuberculosis (TB) patients, which were maintained in the electronic database of mandatory notifications (NIKSHAY Portal) between 2017 and 2022, were reviewed. A total of 54 patients were included after excluding five patients with ongoing treatment. Results: Of 54 patients, 41 (75.9%) were cured, which was classified under favorable outcome, and the rest were classified under unfavorable outcome. Phenotypic, high-level mutation ( katG ) was found in 48 (88.9%) patients. Kaplan-Meier curves show that survival probabilities increase in weeks with regular intake of drugs. Conclusion: Our study found that those with younger ages and males were more affected. We found favorable outcomes in the majority of patients.

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Isoniazid mono-resistant tuberculosis: Time to take it seriously

Cited by 11 publications

References 19 publications

The impact of diabetes mellitus on drug resistance in patients with newly diagnosed tuberculosis: a systematic review and meta-analysis

The impact of diabetes mellitus on drug resistance in patients with newly diagnosed tuberculosis: a systematic review and meta-analysis

Poor treatment outcome and associated risk factors among patients with isoniazid mono-resistant tuberculosis: A systematic review and meta-analysis

A Retrospective Analysis of Clinico-Demographic and Genetic Characteristics and Treatment Outcomes in Isoniazid Mono-Resistant Tuberculosis Patients: A Single-Center Study

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