Traitement de la tuberculose

Nicolet, G; Rochat, Thierry; Jp, Zellweger

doi:10.4414/fms.2003.04888

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…Mostly varying between 95 and 99% [16,24,25], these could not take into account the results of new scientific discoveries showing the lack of specificity of the TST, and may for this reason lead to a systematic bias by overestimating the number of contacts potentially infected and, therefore, the number of cases prevented as the numerator of the incremental cost-effectiveness ratio. The present authors set out to assess the consequences for cost-effectiveness of screening and treating LTBI patients in Switzerland on the basis of current ''reallife'' results in a comparative LTBI screening study that compared the new T-SPOT.TB assay with TST-based strategies among close contacts of infectious pulmonary TB source cases.…”

Section: Discussionmentioning

confidence: 99%

“…Although hospitalisation is recommended for smear-positive cases according to the current guidelines [24], only ,84% of those had been treated as in-patients in 2004, with an average stay in hospital of ,25 days; 27% of the remaining pulmonary TB cases had been hospitalised (average stay 21 days) and 16% of the nonpulmonary TB cases (average stay 10 days), for whom hospitalisation is optional (if there is comorbidity; individual assessment by the Swiss Federal Office of Public Health, not including long-term in-patients).…”

Section: Epidemiological Datamentioning

confidence: 99%

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Cost-effectiveness of interferon-γ release assay testing for the treatment of latent tuberculosis

Diel

Wrighton-Smith²,

Jp³

2007

Eur Respir J

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The aim of the present study was to assess the cost-effectiveness of the new T-SPOT.TB assay versus the tuberculin skin test (TST) for screening contacts for latent tuberculosis (TB) infection in Switzerland.Health and economic outcomes of isoniazid treatment of 20-and 40-yr-old close contacts were compared in a Markov model over a 20-yr period following screening with TST only (at three cutoff values) and T-SPOT.TB alone or in combination with the TST.T-SPOT.TB-based treatment was cost-effective at J11,621 and J23,692 per life-year-gained (LYG) in the younger and older age group, respectively. No TST-based programmes were costeffective, except at a 15-mm cut-off in the younger group only, where the cost-effectiveness (J26,451?LYG -1 ) fell just below the willingness-to-pay threshold. Combination of the TST with T-SPOT.TB slightly reduced the total cost compared with the T-SPOT.TB alone by 4.4 and 5.0% in the younger and older groups respectively. The number of contacts treated to avoid one case of TB decreased from 50 (95% confidence interval 32-106) with the TST (10-mm cut-off) to 18 (95%CI 11-43) if T-SPOT.TB was used. Using T-SPOT.TB alone or in combination with the tuberculin skin test for screening of close contacts before latent tuberculosis infection treatment is highly cost-effective in reducing the disease burden of tuberculosis.KEYWORDS: Cost-effectiveness, interferon-c release assay, latent tuberculosis infection, latent tuberculosis infection treatment, tuberculosis S creening the contacts of patients with tuberculosis (TB) is recommended as a strategy to detect infected persons who may develop the disease at a later time. It has been demonstrated that preventive treatment, mainly with isoniazid, decreases the number of future cases of TB. This strategy is therefore recommended in countries with a low incidence rate of TB, in order to further decrease the burden of disease [1]. The effectiveness and cost-effectiveness of these programmes are strongly affected by the accuracy of identifying truly infected individuals who have a risk of developing future disease. Owing to the limited sensitivity and specificity of the tuberculin skin test (TST), it follows that the current cost-effectiveness of screening may be improved if more accurate tools are used for screening for latent tuberculosis infection (LTBI).Numerous studies screening recent contacts of infectious TB patients for LTBI using the new highly specific interferon-c release assays (IGRA) have recently been published [2][3][4][5][6][7], but no study has produced cost-effectiveness data. In two papers [8,9] the way in which IGRA can be used for cost-saving in initial screening has been discussed. However, the long-term economic consequences and healthcare outcomes of this new approach for detecting Mycobacterium tuberculosis infection were not examined in the context of subsequent treatment of LTBI in comparison with existing programmes based upon the TST.As intervention options in all therapeutic areas grow, government and third-party...

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Section: Discussionmentioning

confidence: 99%

Section: Epidemiological Datamentioning

confidence: 99%

Cost-effectiveness of interferon-γ release assay testing for the treatment of latent tuberculosis

Diel

Wrighton-Smith²,

Jp³

2007

Eur Respir J

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“…Certains patients ont tendance à interrompre leur traitement une fois les symptômes disparus. Il est, en effet, difficile de maintenir la motivation du patient et de conduire jusqu'à son terme un traitement long [20]. Après une interruption de traitement, les germes subissent également une mutation qui les rend résistants aux médicaments concernés.…”

Section: Discussionunclassified

“…Cette situation est responsable de l'apparition d'importants effets indésirables et d'importantes interactions médicamenteuses. Par conséquent, les patients présentant cette co-infection ont un plus grand risque d'interrompre leur traitement antituberculeux [20]. Par ailleurs, la prévalence du VIH/SIDA à Madagascar est encore faible.…”

Section: Discussionunclassified

Facteurs d’échec au traitement antituberculeux à Antananarivo : étude cas-témoin

Rakotonirina,

Razafimanampy,

Mandrosovololona

et al. 2011

Rev méd Madag

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Introduction. The failure to tuberculosis treatment could lead to drug resistance. The study aimed to determine the socioeconomic profile of patients who present treatment failure and to identify the failure factors. Methods. It is a case-control study conducted from 1 January 2006 to July 31, 2009. Cases (n = 54) were patients with smear-positive pulmonary tuberculosis for whom treatment was failed. For each case, two controls (those who had succeeded the treatment) were chosen. Individ- ual interviews were conducted to identify failure factors. Results. The sex ratio was 2.9 and the mean age (± SD) was 35.6 (± 11.5) years. The Body Mass Index of cases is significantly lower than controls (16.5 versus 17.6, p = 0.001) at the beginning of treatment. The cases lost weight but controls earn about 5.3 kg during treatment. Regarding cases, the alcoholism and smoking were more encountered. Treatment interruption was significantly associated with failure (OR: 14.1 [4.5-44.3]). Conclusion. These failure factors to tuberculosis treatment should be considered when designing new strategies against tuberculosis.

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“…However, the rate of reduction does not meet the objective set by the NPAA, which aims to reduce the incidence of all forms of tuberculosis (FTT) by at least 6% per year from 2010 [6]. This can be explained by the emergence of resistant germs, therapeutic failures and relapses, which are three factors likely to increase the risk of the disease spreading to the surrounding population [7].…”

mentioning

confidence: 99%

Factors Associated with Treatment Failure for Microscopy-positive Pulmonary Tuberculosis at the General Reference Hospital of Beni (DR Congo) between 2010 and 2020: Case-control Study

Baudouin

Pascal

Franck³

et al. 2022

IJTDH

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Introduction: Failure to treat microscopy-positive pulmonary tuberculosis (MPT+) poses a risk to public health through the spread of infection and could be a gateway to anti-tuberculosis drug resistance. The aim of this study was to describe the epidemiological characteristics of PMT+ TB patients with treatment failure, to measure the degree of association between the various factors and TB treatment failure, and to formulate recommendations for improving NTP activities. Methods: This is a retrospective case-control study conducted from 1 January 2010 to 31 December 2020 at the CDTMR of the General Referral Hospital of Beni. The cases are patients treated for PMT+ and who had a therapeutic failure. Three controls for each case were selected among patients with PMT+ who were declared cured. Data analysis was performed using Epi-Info version 3.5.3 for Windows. Results: 128 patients were included in the study. 32 patients were treatment failures. The mean age of cases and controls was 42 years (+/- 14), the M/F sex ratio was 31 and 2.4 in cases and controls respectively, urban residents accounted for 90.3% and 83.2% in cases and controls respectively. Bivariate analysis showed a significant association between treatment failure and weight loss at first control (OR=1.55), non-decrease in bacillary density at first control (OR=25.5) and treatment discontinuation (OR=20.5). After adjustment, weight loss of 1 kg (adjusted OR=1.92), no decrease in BAAR density (adjusted OR=8.30) and treatment discontinuation (adjusted OR=12.2) remained significantly associated with treatment failure. Conclusion: Active surveillance should be instituted in TB patients with PMT+ who present at first check-up with weight loss, non-decrease in bacillary density on direct examination and/or a notion of treatment discontinuation.

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Traitement de la tuberculose

Cited by 4 publications

References 22 publications

Cost-effectiveness of interferon-γ release assay testing for the treatment of latent tuberculosis

Cost-effectiveness of interferon-γ release assay testing for the treatment of latent tuberculosis

Facteurs d’échec au traitement antituberculeux à Antananarivo : étude cas-témoin

Factors Associated with Treatment Failure for Microscopy-positive Pulmonary Tuberculosis at the General Reference Hospital of Beni (DR Congo) between 2010 and 2020: Case-control Study

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