Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries

A. Trebucq; V. Schwoebel; Z. Kashongwe; A. Bakayoko; C. Kuaban; J. Noeske; S. Hassane; B. Souleymane; A. Piubello; F. Ciza; V. Fikouma; M. Gasana; M. Ouedraogo; M. Gninafon; A. Van Deun; D. M. Cirillo; K. G. Koura; H. L. Rieder

doi:10.5588/ijtld.17.0498

Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries

A. Trebucq, V. Schwoebel, Z. Kashongwe, A. Bakayoko, C. Kuaban, J. Noeske, S. Hassane, B. Souleymane, A. Piubello, F. Ciza, V. Fikouma, M. Gasana, M. Ouedraogo, M. Gninafon, A. Van Deun, D. M. Cirillo, K. G. Koura, H. L. Rieder

Mycobacteriology

Research output: Contribution to journal › A1: Web of Science-article › peer-review

Abstract

SETTING: Nine countries in West and Central Africa.

OBJECTIVE : To assess outcomes and adverse drug events of a standardised 9-month treatment regimen for multidrug-resistant tuberculosis (MDR-TB) among patients never previously treated with second-line drugs.

DESIGN: Prospective observational study of MDR-TB patients treated with a standardised 9-month regimen including moxifloxacin, clofazimine, ethambutol (EMB) and pyrazinamide (PZA) throughout, supplemented by kanamycin, prothionamide and high-dose isoniazid during an intensive phase of a minimum of 4 to a maximum of 6 months.

RESULTS : Among the 1006 MDR-TB patients included in the study, 200 (19.9%) were infected with the human immunodeficiency virus (HIV). Outcomes were as follows: 728 (72.4%) cured, 93 (9.2%) treatment completed (81.6% success), 59 (5.9%) failures, 78 (7.8%) deaths, 48 (4.8%) lost to follow-up. The proportion of deaths was much higher among HIV-infected patients (19.0% vs. 5.0%). Treatment success did not differ by HIV status among survivors. Fluoroquinolone resistance was the main cause of failure, while resistance to PZA, ethionamide or EMB did not influence bacteriological outcome. The most important adverse drug event was hearing impairment (11.4% severe deterioration after 4 months).

CONCLUSIONS : The study results support the use of the short regimen recently recommended by the World Health Organization. Its high level of success even among HIV-positive patients promises substantial improvements in TB control.

Original language	English
Journal	International Journal of Tuberculosis and Lung Disease
Volume	22
Issue number	1
Pages (from-to)	17-25
Number of pages	10
ISSN	1027-3719
DOIs	https://doi.org/10.5588/ijtld.17.0498
Publication status	Published - 2018

Keywords

tuberculosis
multidrug resistance
treatment
short-course
cohort studies
MDR-TB
FLUOROQUINOLONE
PYRAZINAMIDE
MOXIFLOXACIN

Access to Document

10.5588/ijtld.17.0498

Cite this

Trebucq, A., Schwoebel, V., Kashongwe, Z., Bakayoko, A., Kuaban, C., Noeske, J., Hassane, S., Souleymane, B., Piubello, A., Ciza, F., Fikouma, V., Gasana, M., Ouedraogo, M., Gninafon, M., Van Deun, A., Cirillo, D. M., Koura, K. G., & Rieder, H. L. (2018). Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries. International Journal of Tuberculosis and Lung Disease, 22(1), 17-25. https://doi.org/10.5588/ijtld.17.0498

@article{0c4ac02161874e9b82ff6ee179c7f50b,

title = "Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries",

abstract = "SETTING: Nine countries in West and Central Africa.OBJECTIVE : To assess outcomes and adverse drug events of a standardised 9-month treatment regimen for multidrug-resistant tuberculosis (MDR-TB) among patients never previously treated with second-line drugs.DESIGN: Prospective observational study of MDR-TB patients treated with a standardised 9-month regimen including moxifloxacin, clofazimine, ethambutol (EMB) and pyrazinamide (PZA) throughout, supplemented by kanamycin, prothionamide and high-dose isoniazid during an intensive phase of a minimum of 4 to a maximum of 6 months.RESULTS : Among the 1006 MDR-TB patients included in the study, 200 (19.9%) were infected with the human immunodeficiency virus (HIV). Outcomes were as follows: 728 (72.4%) cured, 93 (9.2%) treatment completed (81.6% success), 59 (5.9%) failures, 78 (7.8%) deaths, 48 (4.8%) lost to follow-up. The proportion of deaths was much higher among HIV-infected patients (19.0% vs. 5.0%). Treatment success did not differ by HIV status among survivors. Fluoroquinolone resistance was the main cause of failure, while resistance to PZA, ethionamide or EMB did not influence bacteriological outcome. The most important adverse drug event was hearing impairment (11.4% severe deterioration after 4 months).CONCLUSIONS : The study results support the use of the short regimen recently recommended by the World Health Organization. Its high level of success even among HIV-positive patients promises substantial improvements in TB control.",

keywords = "tuberculosis, multidrug resistance, treatment, short-course, cohort studies, MDR-TB, FLUOROQUINOLONE, PYRAZINAMIDE, MOXIFLOXACIN",

author = "A. Trebucq and V. Schwoebel and Z. Kashongwe and A. Bakayoko and C. Kuaban and J. Noeske and S. Hassane and B. Souleymane and A. Piubello and F. Ciza and V. Fikouma and M. Gasana and M. Ouedraogo and M. Gninafon and {Van Deun}, A. and Cirillo, {D. M.} and Koura, {K. G.} and Rieder, {H. L.}",

note = "PPU",

year = "2018",

doi = "10.5588/ijtld.17.0498",

language = "English",

volume = "22",

pages = "17--25",

journal = "International Journal of Tuberculosis and Lung Disease",

issn = "1027-3719",

publisher = "International Union Against Tuberculosis and Lung Disease",

number = "1",

}

Trebucq, A, Schwoebel, V, Kashongwe, Z, Bakayoko, A, Kuaban, C, Noeske, J, Hassane, S, Souleymane, B, Piubello, A, Ciza, F, Fikouma, V, Gasana, M, Ouedraogo, M, Gninafon, M, Van Deun, A, Cirillo, DM, Koura, KG & Rieder, HL 2018, 'Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries', International Journal of Tuberculosis and Lung Disease, vol. 22, no. 1, pp. 17-25. https://doi.org/10.5588/ijtld.17.0498

TY - JOUR

T1 - Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries

AU - Trebucq, A.

AU - Schwoebel, V.

AU - Kashongwe, Z.

AU - Bakayoko, A.

AU - Kuaban, C.

AU - Noeske, J.

AU - Hassane, S.

AU - Souleymane, B.

AU - Piubello, A.

AU - Ciza, F.

AU - Fikouma, V.

AU - Gasana, M.

AU - Ouedraogo, M.

AU - Gninafon, M.

AU - Van Deun, A.

AU - Cirillo, D. M.

AU - Koura, K. G.

AU - Rieder, H. L.

N1 - PPU

PY - 2018

Y1 - 2018

N2 - SETTING: Nine countries in West and Central Africa.OBJECTIVE : To assess outcomes and adverse drug events of a standardised 9-month treatment regimen for multidrug-resistant tuberculosis (MDR-TB) among patients never previously treated with second-line drugs.DESIGN: Prospective observational study of MDR-TB patients treated with a standardised 9-month regimen including moxifloxacin, clofazimine, ethambutol (EMB) and pyrazinamide (PZA) throughout, supplemented by kanamycin, prothionamide and high-dose isoniazid during an intensive phase of a minimum of 4 to a maximum of 6 months.RESULTS : Among the 1006 MDR-TB patients included in the study, 200 (19.9%) were infected with the human immunodeficiency virus (HIV). Outcomes were as follows: 728 (72.4%) cured, 93 (9.2%) treatment completed (81.6% success), 59 (5.9%) failures, 78 (7.8%) deaths, 48 (4.8%) lost to follow-up. The proportion of deaths was much higher among HIV-infected patients (19.0% vs. 5.0%). Treatment success did not differ by HIV status among survivors. Fluoroquinolone resistance was the main cause of failure, while resistance to PZA, ethionamide or EMB did not influence bacteriological outcome. The most important adverse drug event was hearing impairment (11.4% severe deterioration after 4 months).CONCLUSIONS : The study results support the use of the short regimen recently recommended by the World Health Organization. Its high level of success even among HIV-positive patients promises substantial improvements in TB control.

AB - SETTING: Nine countries in West and Central Africa.OBJECTIVE : To assess outcomes and adverse drug events of a standardised 9-month treatment regimen for multidrug-resistant tuberculosis (MDR-TB) among patients never previously treated with second-line drugs.DESIGN: Prospective observational study of MDR-TB patients treated with a standardised 9-month regimen including moxifloxacin, clofazimine, ethambutol (EMB) and pyrazinamide (PZA) throughout, supplemented by kanamycin, prothionamide and high-dose isoniazid during an intensive phase of a minimum of 4 to a maximum of 6 months.RESULTS : Among the 1006 MDR-TB patients included in the study, 200 (19.9%) were infected with the human immunodeficiency virus (HIV). Outcomes were as follows: 728 (72.4%) cured, 93 (9.2%) treatment completed (81.6% success), 59 (5.9%) failures, 78 (7.8%) deaths, 48 (4.8%) lost to follow-up. The proportion of deaths was much higher among HIV-infected patients (19.0% vs. 5.0%). Treatment success did not differ by HIV status among survivors. Fluoroquinolone resistance was the main cause of failure, while resistance to PZA, ethionamide or EMB did not influence bacteriological outcome. The most important adverse drug event was hearing impairment (11.4% severe deterioration after 4 months).CONCLUSIONS : The study results support the use of the short regimen recently recommended by the World Health Organization. Its high level of success even among HIV-positive patients promises substantial improvements in TB control.

KW - tuberculosis

KW - multidrug resistance

KW - treatment

KW - short-course

KW - cohort studies

KW - MDR-TB

KW - FLUOROQUINOLONE

KW - PYRAZINAMIDE

KW - MOXIFLOXACIN

U2 - 10.5588/ijtld.17.0498

DO - 10.5588/ijtld.17.0498

M3 - A1: Web of Science-article

SN - 1027-3719

VL - 22

SP - 17

EP - 25

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

IS - 1

ER -

Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries

Abstract

Keywords

Access to Document

Fingerprint

Cite this