Effectiveness and Safety of a Shorter Treatment Regimen in a Setting with a High Burden of Multidrug-Resistant Tuberculosis

Aleksandr Trubnikov, Arax Hovhannesyan, Kristina Akopyan, Ana Ciobanu, Dilbar Sadirova, Lola Kalandarova, Nargiza Parpieva and Jamshid Gadoev
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Aleksandr Trubnikov: Abt Associates, Rashidov Street C-4, 20A, Yunosobod District, Tashkent 100093, Uzbekistan
Arax Hovhannesyan: World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark
Kristina Akopyan: World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark
Ana Ciobanu: World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark
Dilbar Sadirova: Tashkent City Center of Phthisiology and Pulmonology, Lutfi Street 33/1, 7th District, Chilonzor District, Tashkent 100043, Uzbekistan
Lola Kalandarova: Tashkent City Center of Phthisiology and Pulmonology, Lutfi Street 33/1, 7th District, Chilonzor District, Tashkent 100043, Uzbekistan
Nargiza Parpieva: Republican Specialized Scientific Practical Medical Centre of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, Sh. Alimov 1, Little Ring Road, Tashkent 100086, Uzbekistan
Jamshid Gadoev: World Health Organization Uzbekistan Country Office, 16, Tarobiy Street, Tashkent 100100, Uzbekistan

IJERPH, 2021, vol. 18, issue 8, 1-16

Abstract: Treatment of drug-resistant tuberculosis is lengthy, insufficiently effective, and toxic. Since 2016, the World Health Organization has recommended shorter treatment regimens (STR). We assessed effectiveness and predictors of drug adverse events (DAE) among patients treated with STR. There were 95 consecutive rifampicin-resistant patients enrolled in STR in Tashkent between June 2018 and September 2019. Of these, 66.3% were successfully treated, 17.9% suffered failed treatment, 7.4% died, 5.3% were lost to follow-up and 3.2% were not evaluated. No recurrence was identified in 54 patients after 12 months of successful treatment completion. There were 47 reported DAE: the incidence rate was 6.15 DAE per 100 person-months-of-treatment. Any DAE was reported in 38 (40%) patients and grade 3/4 DAE were recorded in 21 (22.1%) patients. Median time to DAE was 101 (interquartile range 64–139) days. The most frequently encountered DAE were gastro-intestinal disorders, followed by hepatotoxicity and ototoxicity. The most commonly offending drug inducing DAE was protionamide. The dose was temporarily interrupted in 55.3% of DAE, reduced in 8.5% of DAE and permanently withdrawn in another 8.5% of DAE. HIV status was the only predictor associated with increased hazard of DAE. In Uzbekistan STR showed moderate effectiveness and safety, although treatment failure was high.

Keywords: shorter treatment regimen; drug adverse event; RR-TB treatment outcome; operational research; SORT IT; Uzbekistan (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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