Treatment outcome of patients having extensively drug-resistant tuberculosis in Gujarat, India

Prajapati, Krunal; Mishra, Vishal; Desai, Mira; Solanki, Rajesh; Naik, Purvi

doi:10.4103/ijmy.ijmy_59_17

Cited by 16 publications

(10 citation statements)

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“…This implies that XDR-TB patients with a baseline body weight of <40 kg were significantly more likely to die than those with a baseline body weight of ≥40 kg. Similar to our finding, the patients' low body weight/body mass index at baseline visit has been reported as a risk factor for poor treatment outcomes among XDR-TB (Kwon et al, 2008;Jacobson et al, 2010;Tang et al, 2013;Prajapati et al, 2017) and MDR-TB patients (Ahmad et al, 2015;Javaid et al, 2017;Khan et al, 2019) by studies conducted elsewhere. One of the reasons of poor systemic availability of oral anti-TB drugs is their poor absorption from gastrointestinal tract (GIT).…”

Section: Discussionsupporting

confidence: 91%

“…In the current study, a total of 149 (36.9%) patients died. The mortality rate in our cohort was comparatively higher than the frequency of deaths observed among XDR-TB patients in Georgia (15.09%) (Frank et al, 2019), Estonia (17.54%) (Kliiman & Altraja, 2009) and Russia (23.61%) (Yunusbaeva et al, 2019), and lower than that observed in India (51.8%) (Prajapati et al, 2017) and South Africa (43 and 53%) (Pietersen et al, 2015;Yuengling et al, 2018). The relatively low mortality rate in the aforementioned studies could be due to the hiding of death by high LTUF rate ranging from 14.81 to 37.7% in these studies (Kliiman and Altraja, 2009;Frank et al, 2019;Yunusbaeva et al, 2019) as compared to 7.7% in our cohort.…”

Section: Discussioncontrasting

confidence: 78%

“…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: Discussionmentioning

confidence: 54%

“…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: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 54%

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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“…Malheureusement, aucun test de sensibilité des autres médicaments de deuxième ligne n'était disponible, ce qui aurait pu entraîner une administration inutile de médicaments inefficaces. Cela nécessite la mise en place d'infrastructures et de laboratoires dotés des dernières technologies pour tester la sensibilité aux autres médicaments [16]. Chaque patient a été suivi mensuellement pour l'évaluation clinique (poids corporel), l'examen de la culture des expectorations, la radiographie thoracique, un bilan hématologique et biochimique systématique ainsi qu’un ECG en cas de prise de délamanide et la surveillance des effets indésirables jusqu'à achèvement de la durée du traitement.…”

Section: Discussionunclassified

Tuberculose extrapulmonaire multi résistante: à propos de 7 cas

Haddaoui¹,

Mrabet²,

Aharmim³

et al. 2019

Pan Afr Med J

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La tuberculose multi-résistante constitue un défi majeur pour l’Organisation Mondiale de la Santé. Son incidence croissante, les difficultés diagnostiques et thérapeutiques en font un problème de santé publique surtout dans les pays en développement. Nous rapportons deux cas de tuberculose résistante extra pulmonaire exclusive (ganglionnaire et ostéo-articulaire) et cinq cas associant à l’atteinte pulmonaire d’autres localisations extra pulmonaires (pleurale, ganglionnaire, anale et neuro-méningée) chez des patients hospitalisés à l’hôpital Moulay Youssef de Rabat. Ces cas illustrent la problématique de la résistance aux antituberculeux et soulèvent le rôle des tests génotypiques dans le diagnostic de la tuberculose extra-pulmonaire.

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Linezolid for drug-resistant pulmonary tuberculosis

Singh

Cocker

Ryan

et al. 2019

Cochrane Database of Systematic Reviews

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BackgroundLinezolid was recently re‐classified as a Group A drug by the World Health Organization (WHO) for treatment of multi‐drug resistant tuberculosis (MDR‐TB) and extensively drug‐resistant tuberculosis (XDR‐TB), suggesting that it should be included in the regimen for all patients unless contraindicated. Linezolid use carries a considerable risk of toxicity, with the optimal dose and duration remaining unclear. Current guidelines are mainly based on evidence from observational non‐comparative studies.ObjectivesTo assess the efficacy of linezolid when used as part of a second‐line regimen for treating people with MDR and XDR pulmonary tuberculosis, and to assess the prevalence and severity of adverse events associated with linezolid use in this patient group.Search methodsWe searched the following databases: the Cochrane Infectious Diseases Specialized Register; CENTRAL; MEDLINE; Embase; and LILACS up to 13 July 2018. We also checked article reference lists and contacted researchers in the field.Selection criteriaWe included studies in which some participants received linezolid, and others did not. We included randomized controlled trials (RCTs) of linezolid for MDR and XDR pulmonary tuberculosis to evaluate efficacy outcomes. We added non‐randomized cohort studies to evaluate adverse events.Primary outcomes were all‐cause and tuberculosis‐associated death, treatment failure, and cure. Secondary outcomes were treatment interrupted, treatment completed, and time to sputum culture conversion. We recorded frequency of all and serious adverse events, adverse events leading to drug discontinuation or dose reduction, and adverse events attributed to linezolid, particularly neuropathy, anaemia, and thrombocytopenia.Data collection and analysisTwo review authors (BS and DC) independently assessed the search results for eligibility and extracted data from included studies. All review authors assessed risk of bias using the Cochrane ‘Risk of bias' tool for RCTs and the ROBINS‐I tool for non‐randomized studies. We contacted study authors for clarification and additional data when necessary.We were unable to perform a meta‐analysis as one of the RCTs adopted a study design where participants in the study group received linezolid immediately and participants in the control group received linezolid after two months, and therefore there were no comparable data from this trial. We deemed meta‐analysis of non‐randomized study data inappropriate.Main resultsWe identified three RCTs for inclusion. One of these studies had serious problems with allocation of the study drug and placebo, so we could not analyse data for intervention effect from it. The remaining two RCTs recruited 104 participants. One randomized 65 participants to receive linezolid or not, in addition to a background regimen; the other randomized 39 participants to addition of linezolid to a background regimen immediately, or after a delay of two months. We included 14 non‐randomized cohort studies (two prospective, 12 retrospective), with a total of 1678 partici...

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Treatment outcome of patients having extensively drug-resistant tuberculosis in Gujarat, India

Abstract: Treatment outcome of XDR TB patients is extremely poor with high mortality rate.

Cited by 16 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

Tuberculose extrapulmonaire multi résistante: à propos de 7 cas

Linezolid for drug-resistant pulmonary tuberculosis

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