Risk factors for unfavourable treatment outcomes among rifampicin-resistant tuberculosis patients in Tajikistan

Makhmudova, Mavluda; Maxsumova, Z; Rajabzoda, Aslidin Saidburhon; Makhmadov, A; Hof, Susan van den; Mirtskhulava, Veriko

doi:10.5588/ijtld.18.0311

Cited by 18 publications

(15 citation statements)

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“…In the present cohort, the treatment success rate (40.6%) was comparable with the global treatment success rate (39%) among XDR-TB patients (2016 cohort) (World Health Organization, 2018). However, it was better than the rates reported from Tajikistan (5.6%) (Makhmudova et al, 2019), Russia (12%) (Yunusbaeva et al, 2019), South Africa (4 and 31.4%) (Yuengling et al, 2018;Te Riele et al, 2019), China (14.6 and 30%) (Alene et al, 2017;He et al, 2017), India (25.9%) (Prajapati et al, 2017) and Georgia (33%) (Frank et al, 2019), and lower than the ones reported from Brazil (48.4%) (Gallo et al, 2018) and Argentina (65%) (Abbate et al, 2012).…”

Section: Discussioncontrasting

confidence: 54%

“…To the best of our knowledge, this is the first study which evaluated the treatment outcomes and factors associated with unsuccessful outcomes among XDR-TB patients enrolled for treatment at 27 PMDT units all over Pakistan. As the previously published individual cohorts from different countries have included a relatively small number of XDR-TB patients ranging from 12 to 195 (Kwon et al, 2008;Kliiman & Altraja, 2009;Pietersen et al, 2015;Yuengling et al, 2018;Makhmudova et al, 2019;Yunusbaeva et al, 2019), the large sample size of 404 XDR-TB patients from all over the country is the major strength of this study. In the present cohort, the treatment success rate (40.6%) was comparable with the global treatment success rate (39%) among XDR-TB patients (2016 cohort) (World Health Organization, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Globally, the treatment success rates for drug susceptible TB, MDR-TB and XDR-TB are 85% (2017 cohort), 56% (2017 cohort) and 39% (2016 cohort), respectively (World Health Organization, 2018;World Health Organization, 2020). The previously reported treatment success rate of various individual cohorts of XDR-TB patients (n 12-195) ranges from 4 to 65% (Abbate et al, 2012;Alene et al, 2017;He et al, 2017;Prajapati et al, 2017;Gallo et al, 2018;Yuengling et al, 2018;Frank et al, 2019;Makhmudova et al, 2019;Te Riele et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Treatment Outcomes of Extensively Drug-Resistant Tuberculosis in Pakistan: A Countrywide Retrospective Record Review

Abubakar

Ahmad

Ghafoor³

et al. 2021

Front. Pharmacol.

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Background: The current study is conducted with the aim to the fill the gap of information regarding treatment outcomes and variables associated with unsuccessful outcome among XDR-TB patients from Pakistan.Methods: A total of 404 culture confirmed XDR-TB patients who received treatment between 1st May 2010 and June 30, 2017 at 27 treatment centers all over Pakistan were retrospectively followed until their treatment outcomes were reported. A p-value <0.05 reflected a statistical significant association.Results: The patients had a mean age 32.9 ± 14.1 years. The overall treatment success rate was 40.6% (95% confidence interval [CI]:35.80–45.60%). A total of 155 (38.4%) patients were declared cured, 9 (2.2%) completed treatment, 149 (36.9%) died, 60 (14.9%) failed treatment and 31 (7.7%) were lost to follow up (LTFU). The results of the multivariate binary logistic regression analysis revealed that the patients’ age of >60 years (OR = 4.69, 95%CI:1.57–15.57) and receiving high dose isoniazid (OR = 2.36, 95%CI:1.14–4.85) had statistically significant positive association with death, whereas baseline body weight >40 kg (OR = 0.43, 95%CI:0.25–0.73) and sputum culture conversion in the initial two months of treatment (OR = 0.33, 95%CI:0.19–0.58) had statistically significant negative association with death. Moreover, male gender had statistically significant positive association (OR = 1.92, 95%CI:1.04–3.54) with LTFU.Conclusion: The treatment success rate (40.6%) of XDR-TB patients in Pakistan was poor. Providing special attention and enhanced clinical management to patients with identified risk factors for death and LTFU in the current cohort may improve the treatment outcomes.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment Outcomes of Extensively Drug-Resistant Tuberculosis in Pakistan: A Countrywide Retrospective Record Review

Abubakar

Ahmad

Ghafoor³

et al. 2021

Front. Pharmacol.

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“…The poor treatment outcome is the share of different risk factors. Among the risk factors are being HIV positive, the weight of the patient, age of the patient, presence of other comorbidities or co-infections, smoking, alcohol, patient condition, delay to start treatment, resistance to more than two anti-TB drugs and involvement of TB outside the lungs are reported (Chung-Delgado et al, 2015;Ketema et al, 2019;Bajehson et al, 2019;Balabanova et al, 2016;Chingonzoh et al, 2018;Khan et al, 2015;Farley et al, 2011;Li et al, 2016;Makhmudova et al, 2019;Kurbatova et al, 2012;Bei et al, 2018;Alene et al, 2017;Limenih and Workie, 2019;Woldeyohannes et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Poor treatment outcome and its predictors among drug-resistant tuberculosis patients in Ethiopia: A systematic review and meta-analysis

Alemu

Bitew

Worku

2020

International Journal of Infectious Diseases

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To assess poor treatment outcomes and their predictors among drug-resistant tuberculosis patients treated in Ethiopia. Methods: Data were searched from both electronic databases and other sources. From the whole search, 404 articles were reviewed and 17 articles that fulfilled the inclusion criteria were included in the analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed and Joanna Briggs Institute Critical Appraisal checklist was used for assessing the quality. Risk of bias was assessed using forest plot and Egger's regression test. Data were analyzed using STATA version 15 and Review Manager Software version 5.3. Results: The overall pooled proportion of poor treatment outcome and mortality was 17.86% and 15.13% respectively. The incidence density rate of poor treatment outcome and mortality was 10.41/1000 person-months and 9.28/1000 person-months respectively. Survival status and successful treatment outcomes were 76.97% and 63.82% respectively. HIV positivity, non-HIV comorbidities, clinical complications, extrapulmonary involvement, undernutrition, anemia, treatment delay, lower body weight, and older age were the predictors of poor treatment outcome. Conclusion:Better survival and treatment success rates were noted in Ethiopia as compared to the global average. The majority of the poor treatment outcomes occurred within the intensive phase. Early initiation of anti-tuberculosis treatment would be important for successful treatment outcomes.

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“…Rifampicin. It is an antibiotic and used to treat infection of Mycobacterium tuberculosis, the bacteria that cause tuberculosis [99,100]. While phenobarbital is a prototype inducer of cytochrome P450 2B subfamilies [95], rifampicin is a prototype inducer that induce cytochrome P450 3A enzymes [101][102][103].…”

Section: Fluorouracil (5-fu)mentioning

confidence: 99%

Carboxylesterases: Pharmacological Inhibition Regulated Expression and Transcriptional Involvement of Nuclear Receptors and other Transcription Factors

Shen

Shi

Yan

2019

Nuclear Receptor Research

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Carboxylesterases (CESs, E.C.3.1.1.1) constitute a large class of enzymes that determine the therapeutic efficacy and toxicity of ester/amide drugs. Without exceptions, all mammalian species studied express multiple forms of carboxylesterases. Two human carboxylesterases, CES1 and CES2, are major contributors to hydrolytic biotransformation. Recent studies have identified therapeutic agents that potently inhibit carboxylesterases-based catalysis. Some of them are reversible whereas others irreversible. The adrenergic antagonist carvedilol, for example, reversibly inhibits CES2 but this carboxylesterase is irreversibly inhibited by orlistat, a popular anti-obesity medicine. Kinetically, the inhibition occurs competitively, non-competitively or in combination, depending on a carboxylesterase. For example, the calcium channel blocker diltiazem competitively inhibits CES1 but non-competitively inhibits CES2. In addition to inhibited catalysis, several therapeutic agents or disease mediators have been shown to regulate the expression of carboxylesterases. For example, the antiepileptic drug phenobarbital induces both human and rodent carboxylesterases, whereas the antibiotic rifampicin induces human carboxylesterases only. Conversely, the proinflammatory cytokine interleukin-6 (IL-6) suppresses the expression of carboxylesterases across species, but depending on the concentrations of glucose in the culture medium. Transactivation, transrepression and altered mRNA stability contribute to the regulated expression. Several nuclear receptors are established to support the regulation including constitutive androstane receptor, glucocorticoid receptor and pregnane X receptor. In addition, non-ligand transcription factors are also involved in the regulation and exemplified by differentiated embryo chondrocyte-1, nuclear factor (erythroid-derived 2)-like 2 and tumor protein p53. These transcription factors coordinate the regulated expression of carboxylesterases, constituting a regulatory network for the hydrolytic biotransformation.

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Risk factors for unfavourable treatment outcomes among rifampicin-resistant tuberculosis patients in Tajikistan

Cited by 18 publications

References 0 publications

Treatment Outcomes of Extensively Drug-Resistant Tuberculosis in Pakistan: A Countrywide Retrospective Record Review

Treatment Outcomes of Extensively Drug-Resistant Tuberculosis in Pakistan: A Countrywide Retrospective Record Review

Poor treatment outcome and its predictors among drug-resistant tuberculosis patients in Ethiopia: A systematic review and meta-analysis

Carboxylesterases: Pharmacological Inhibition Regulated Expression and Transcriptional Involvement of Nuclear Receptors and other Transcription Factors

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