Treatment Outcomes of Isoniazid-Resistant (Rifampicin Susceptible) Tuberculosis Patients in Uzbekistan, 2017–2018

Zayniddin Sayfutdinov, Ajay Kumar, Dilyara Nabirova, Jamshid Gadoev, Laziz Turaev, Sanjar Sultanov, Sevak Alaverdyan and Nargiza Parpieva
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Zayniddin Sayfutdinov: National Reference Laboratory, Tashkent 100086, Uzbekistan
Ajay Kumar: International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi 110016, India
Dilyara Nabirova: United States Centers for Disease Control and Prevention, Central Asia Region, Almaty A25T0A1, Kazakhstan
Jamshid Gadoev: WHO Country Office in Uzbekistan, Tashkent 700029, Uzbekistan
Laziz Turaev: National Reference Laboratory, Tashkent 100086, Uzbekistan
Sanjar Sultanov: National Reference Laboratory, Tashkent 100086, Uzbekistan
Sevak Alaverdyan: Bielefeld Graduate School of Economics and Management (BiGSEM), Bielefeld University, Universitätsstraße, 33615 Bielefeld, Germany
Nargiza Parpieva: National Tuberculosis Programme, Ministry of Health, Tashkent 100086, Uzbekistan

IJERPH, 2021, vol. 18, issue 6, 1-8

Abstract: Tuberculosis patients “resistant to isoniazid and susceptible to rifampicin (Hr-TB)” remain neglected, despite a high burden and poor outcomes. The World Health Organization (WHO) recommends a 6 month regimen consisting of levofloxacin, rifampicin, ethambutol, and pyrazinamide (LRZE) to treat Hr-TB. In contrast, Uzbekistan uses a 9 month regimen (LRZE plus a second-line injectable in the first 3 months). We aimed to assess the treatment outcomes of this novel regimen among Hr-TB patients treated in two regions of Uzbekistan (Fergana and Bukhara) in 2017–2018. We conducted a cohort study involving secondary analysis of routine surveillance data. Of 132 Hr-TB patients, 105 (80%) were successfully treated. Death was the predominant unsuccessful outcome (13, 10%) followed by “treatment failure” (10, 8%) and “lost to follow-up” (4, 2%). High treatment success is an indicator of the potential effectiveness of the novel regimen and adds to the limited global evidence on this issue. However, the sample size was small and there was no comparison group. Since the study was conducted in two regions of Uzbekistan only, the findings have limited generalizability. We recommend future research using an adequate sample size and an appropriate study design (randomized controlled trial or prospective cohort with a control group receiving the WHO-recommended regimen).

Keywords: Central Asia; operational research; Hr-TB; isoniazid resistance; treatment outcome; mono resistance; SORT IT (Structured Operational Research Training Initiative) (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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