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High effectiveness of a 12-month regimen for MDR-TB patients in Cameroon


Kuaban, C; Noeske, J; Rieder, Hans L; Aït-Khaled, N; Abena Foe, J L; Trébucq, A (2015). High effectiveness of a 12-month regimen for MDR-TB patients in Cameroon. The International Journal of Tuberculosis and Lung Disease, 19(5):517-524.

Abstract

SETTING Two specialised multidrug-resistant tuberculosis (MDR-TB) treatment units in Cameroon. OBJECTIVE To assess outcome and adverse drug events with a standardised 12-month regimen for MDR-TB among second-line drug naïve patients. DESIGN Prospective observational study of MDR-TB patients treated with a standardised 12-month regimen including gatifloxacin, clofazimine, prothionamide, ethambutol and pyrazinamide throughout, supplemented by kanamycin and isoniazid during an intensive phase of a minimum of 4 months. Progress was monitored monthly until treatment completion and twice over one year after treatment cessation. RESULTS Eighty-seven potentially eligible patients were lost and never treated due to delayed availability of test results. Among the 150/236 eligible and treated patients, 134 (89%) successfully completed treatment, 10 died, 5 were lost, 1 failed and none relapsed. The patients' mean age was 33.7 years (range 17-68), 73 (49%) were females, 120 (80%) had failed on previous treatment, 30 (20%) were human immunodeficiency virus seropositive, 62 (43%) had a body mass index <18.5 kg/m(2) and 41 (27%) had radiographic involvement of five or six of the six lung zones. The most important adverse drug event was hearing impairment, which occurred in 46 of 106 (43%) patients. CONCLUSIONS These results add further evidence for the usefulness of shorter, standardised regimens among patients without second-line drug resistance.

Abstract

SETTING Two specialised multidrug-resistant tuberculosis (MDR-TB) treatment units in Cameroon. OBJECTIVE To assess outcome and adverse drug events with a standardised 12-month regimen for MDR-TB among second-line drug naïve patients. DESIGN Prospective observational study of MDR-TB patients treated with a standardised 12-month regimen including gatifloxacin, clofazimine, prothionamide, ethambutol and pyrazinamide throughout, supplemented by kanamycin and isoniazid during an intensive phase of a minimum of 4 months. Progress was monitored monthly until treatment completion and twice over one year after treatment cessation. RESULTS Eighty-seven potentially eligible patients were lost and never treated due to delayed availability of test results. Among the 150/236 eligible and treated patients, 134 (89%) successfully completed treatment, 10 died, 5 were lost, 1 failed and none relapsed. The patients' mean age was 33.7 years (range 17-68), 73 (49%) were females, 120 (80%) had failed on previous treatment, 30 (20%) were human immunodeficiency virus seropositive, 62 (43%) had a body mass index <18.5 kg/m(2) and 41 (27%) had radiographic involvement of five or six of the six lung zones. The most important adverse drug event was hearing impairment, which occurred in 46 of 106 (43%) patients. CONCLUSIONS These results add further evidence for the usefulness of shorter, standardised regimens among patients without second-line drug resistance.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:German
Date:May 2015
Deposited On:23 Dec 2015 08:03
Last Modified:05 Apr 2016 19:44
Publisher:International Union Against Tuberculosis and Lung Disease
ISSN:1027-3719
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.5588/ijtld.14.0535
PubMed ID:25868018

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