Tuberculosis recovery in Georgia: implementing more by 24

Kiria, Nana; Lomtadze, Nino; Solomonia, N; Aspindzelashvili, Rusudan; Danelia, Maka; Gabisonia, Irakli; Janjgava, Marina; Khonelidze, Irma; Kipiani, Maia; Tukvadze, Nestani; Blumberg, Henry M.; Kempker, Russell R.; Furin, Jennifer; Avaliani, Zaza

doi:10.1016/s1473-3099(22)00689-2

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Although Georgia has recently made significant progress in reducing the incidence of drug-resistant TB, it is still a work in progress given the complicated baseline of a decade ago [ 16 ]. The drug regimens used when primary drugs fail are considerably more toxic and less effective [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Numerous Asymptomatic Brain Tuberculomas Complicated by Fatal Tuberculous Meningitis

Alavidze,

Shubitidze,

Khodeli

et al. 2024

Cureus

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Tuberculosis (TB) is still one of the most challenging infectious diseases worldwide. Coinfection with HIV increases the likelihood of extrapulmonary involvement, including the tuberculosis of the central nervous system (CNS-TB). CNS-TB often presents as tuberculomas or tuberculous meningitis. Although tuberculomas can be single or multiple, asymptomatic carriage of numerous tuberculomas is seldom reported. We present a case of a 55-year-old man who carried at least 34 tuberculomas of different sizes asymptomatically before developing and succumbing to tuberculous meningitis. Furthermore, we highlight several possible public health challenges that might have complicated his clinical course, suggesting that future studies also focus on these variables alongside more traditional clinical issues.

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Section: Discussionmentioning

confidence: 99%

Numerous Asymptomatic Brain Tuberculomas Complicated by Fatal Tuberculous Meningitis

Alavidze,

Shubitidze,

Khodeli

et al. 2024

Cureus

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Impact of Prior Tuberculosis Treatment With New/Companion Drugs on Clinical Outcomes in Patients Receiving Concomitant Bedaquiline and Delamanid for Multidrug- and Rifampicin-Resistant Tuberculosis

Mikiashvili,

Kempker,

Chakhaia

et al. 2023

Clinical Infectious Diseases

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Background There is scarce data on the clinical outcomes of persons retreated with new/companion anti-tuberculosis (TB) drugs for multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB). We sought to evaluate the efficacy and safety of bedaquiline and delamanid containing regimens among patients with and without prior exposure to the new/companion drugs (bedaquiline, delamanid, linezolid, clofazimine, and fluoroquinolones). Methods We conducted a retrospective cohort study among patients with pulmonary MDR/RR-TB in Georgia who received bedaquiline and delamanid combination as a part of a salvage regimen from November 2017 to December 2020 in a programmatic setting. Results Among 106 persons with a median age of 39.5 years, 44 (41.5%) were previously treated with new/companion TB drugs. Patients with prior exposure to new/companion drugs had higher rates of baseline resistance compared to those without exposure to new/companion TB drugs (bedaquiline 15.2% vs 1.8%, linezolid 22.2% vs 16.7%). Sputum culture conversion rates among patients exposed and not exposed to new/companion drugs were 65.9% vs 98.0%, respectively (p<0.001). Among patients with and without prior new/companion TB drug use, favorable outcome rates were 41.0% and 82.3%, respectively (p<0.001). Treatment adherence in 32 (30.2%) patients was ≤80%. Five of 21 patients (23.8%) who had a baseline and repeat susceptibility test had acquired bedaquiline resistance. QTC/F prolongation (>500 ms) was rare (2.8%). Conclusion Prior exposure to new/companion TB drugs was associated with poor clinical outcomes and acquired drug resistance. Tailoring the TB regimen to each patient's DST results and burden of disease and enhancing adherence support may improve outcomes.

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Tuberculosis recovery in Georgia: implementing more by 24

Cited by 2 publications

References 6 publications

Numerous Asymptomatic Brain Tuberculomas Complicated by Fatal Tuberculous Meningitis

Numerous Asymptomatic Brain Tuberculomas Complicated by Fatal Tuberculous Meningitis

Impact of Prior Tuberculosis Treatment With New/Companion Drugs on Clinical Outcomes in Patients Receiving Concomitant Bedaquiline and Delamanid for Multidrug- and Rifampicin-Resistant Tuberculosis

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