Case report: therapeutic threshold for rifampicin-resistant tuberculosis: a case report from Maputo, Mozambique

Lorena D M Gonzaga; Tinne Gils; Tom Decroo; Bart K M Jacobs; Lutgarde Lynen

doi:10.4269/ajtmh.20-0959

Case report: therapeutic threshold for rifampicin-resistant tuberculosis: a case report from Maputo, Mozambique

Lorena D M Gonzaga, Tinne Gils, Tom Decroo, Bart K M Jacobs, Lutgarde Lynen

HIV and Tuberculosis

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Abstract

We present a case of a patient in Mozambique, who initiated treatment for rifampicin-resistant tuberculosis (RR-TB) without proof of resistance. For this patient, we estimated the probability of RR-TB using likelihood ratios of clinical arguments. The probability of RR-TB in Mozambique, positive HIV status, and treatment failure after a first treatment and after retreatment were included as confirming arguments, and a rapid molecular test showing rifampicin susceptibility as excluding argument. The therapeutic threshold to start treatment for RR-TB is unknown, but probably lower than 47% and should be calculated to guide clinical decisions.

Original language	English
Journal	American Journal of Tropical Medicine and Hygiene
Volume	104
Issue number	4
Pages (from-to)	1317-1320
Number of pages	4
ISSN	0002-9637
DOIs	https://doi.org/10.4269/ajtmh.20-0959
Publication status	Published - 2021

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2021ajtm1317Final published version, 122 KBLicence: CC BY-NC

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abstract = "We present a case of a patient in Mozambique, who initiated treatment for rifampicin-resistant tuberculosis (RR-TB) without proof of resistance. For this patient, we estimated the probability of RR-TB using likelihood ratios of clinical arguments. The probability of RR-TB in Mozambique, positive HIV status, and treatment failure after a first treatment and after retreatment were included as confirming arguments, and a rapid molecular test showing rifampicin susceptibility as excluding argument. The therapeutic threshold to start treatment for RR-TB is unknown, but probably lower than 47% and should be calculated to guide clinical decisions.",

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AU - Gonzaga, Lorena D M

AU - Gils, Tinne

AU - Decroo, Tom

AU - Jacobs, Bart K M

AU - Lynen, Lutgarde

N1 - FTX; OGOA; (CC BY-NC 4.0)

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N2 - We present a case of a patient in Mozambique, who initiated treatment for rifampicin-resistant tuberculosis (RR-TB) without proof of resistance. For this patient, we estimated the probability of RR-TB using likelihood ratios of clinical arguments. The probability of RR-TB in Mozambique, positive HIV status, and treatment failure after a first treatment and after retreatment were included as confirming arguments, and a rapid molecular test showing rifampicin susceptibility as excluding argument. The therapeutic threshold to start treatment for RR-TB is unknown, but probably lower than 47% and should be calculated to guide clinical decisions.

AB - We present a case of a patient in Mozambique, who initiated treatment for rifampicin-resistant tuberculosis (RR-TB) without proof of resistance. For this patient, we estimated the probability of RR-TB using likelihood ratios of clinical arguments. The probability of RR-TB in Mozambique, positive HIV status, and treatment failure after a first treatment and after retreatment were included as confirming arguments, and a rapid molecular test showing rifampicin susceptibility as excluding argument. The therapeutic threshold to start treatment for RR-TB is unknown, but probably lower than 47% and should be calculated to guide clinical decisions.

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JF - American Journal of Tropical Medicine and Hygiene

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Case report: therapeutic threshold for rifampicin-resistant tuberculosis: a case report from Maputo, Mozambique

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