Factors affecting the treatment outcome of injection based shorter MDR-TB regimen at a referral centre in India
Rifampicin-resistant/multidrug-resistant tuberculosis (RR/MDR-TB) is a significant burden on global tuberculosis (TB) prevention and eradication efforts. MDR-TB can be treated, but it is expensive, takes a long time (typically two years), and contains potentially toxic drugs. Under certain conditio...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2022-10-01
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| Series: | Monaldi Archives for Chest Disease |
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| Online Access: | https://www.monaldi-archives.org/index.php/macd/article/view/2396 |
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| author | Kiran B Rupak Singla Neeta Singla Vinay V Kuljeet Singh Madhumita Paul Choudhury Nilotpal Bhattacherjee |
| author_facet | Kiran B Rupak Singla Neeta Singla Vinay V Kuljeet Singh Madhumita Paul Choudhury Nilotpal Bhattacherjee |
| author_sort | Kiran B |
| collection | DOAJ |
| description |
Rifampicin-resistant/multidrug-resistant tuberculosis (RR/MDR-TB) is a significant burden on global tuberculosis (TB) prevention and eradication efforts. MDR-TB can be treated, but it is expensive, takes a long time (typically two years), and contains potentially toxic drugs. Under certain conditions, the WHO recommends standard regimens lasting 9 to 11 months rather than individual regimens lasting at least 18-20 months. The current study sought to identify factors associated with treatment outcome in RR/MDR-TB patients receiving an injection-based regimen for 9-11 months. This ambispective (prospective and retrospective) observational study was conducted at a tertiary tuberculosis institute in New Delhi, India. Between February 2021 and March 2022, patients with RR/MDR-pulmonary TB who received an injection-based shorter regimen were enrolled. Factors related to treatment outcome were investigated and compared in patients who had a successful outcome versus those who did not. A total of 55 patients were enrolled, with 50.91% being successful (cured/treatment completed) and 49.09% failing (including failure, lost to follow up, death, and regimen changed). The following factors were significantly associated with the unsuccessful outcome, according to univariate analysis: BMI (18.5 kg/m2), anaemia, previous anti-TB treatment, bilateral chest X-ray involvement, and far advanced disease on chest X-ray BMI (18.5 kg/m2), anaemia, and far advanced disease on chest X-ray were all significantly associated with mortality. Anaemia was associated with an unsuccessful outcome (p=0.049) and mortality (p=0.048) in the multiple logistic regression analysis. Early treatment initiation, improved nutrition and anaemia, and regular monitoring can all improve RR/MDR-TB patients' outcomes and prognoses.
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| first_indexed | 2024-04-13T23:24:14Z |
| format | Article |
| id | doaj.art-49e5e7c7bab6411397606d6c23859d31 |
| institution | Directory Open Access Journal |
| issn | 1122-0643 2532-5264 |
| language | English |
| last_indexed | 2024-04-13T23:24:14Z |
| publishDate | 2022-10-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj.art-49e5e7c7bab6411397606d6c23859d312022-12-22T02:25:07ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642022-10-0110.4081/monaldi.2022.2396Factors affecting the treatment outcome of injection based shorter MDR-TB regimen at a referral centre in IndiaKiran B0Rupak Singla1Neeta Singla2Vinay V3Kuljeet Singh4Madhumita Paul Choudhury5Nilotpal Bhattacherjee6Department of Tuberculosis and Respiratory Diseases, National Institute Tuberculosis and Respiratory Disease, New DelhiDepartment of Tuberculosis and Respiratory Diseases, National Institute Tuberculosis and Respiratory Disease, New DelhiDepartment of Epidemiology and Public Health, National Institute Tuberculosis and Respiratory Disease, New DelhiDepartment of Tuberculosis and Respiratory Diseases, National Institute Tuberculosis and Respiratory Disease, New DelhiDepartment of Tuberculosis and Respiratory Diseases, National Institute Tuberculosis and Respiratory Disease, New DelhiDepartment of Tuberculosis and Respiratory Diseases, National Institute Tuberculosis and Respiratory Disease, New DelhiDepartment of Tuberculosis and Respiratory Diseases, National Institute Tuberculosis and Respiratory Disease, New Delhi Rifampicin-resistant/multidrug-resistant tuberculosis (RR/MDR-TB) is a significant burden on global tuberculosis (TB) prevention and eradication efforts. MDR-TB can be treated, but it is expensive, takes a long time (typically two years), and contains potentially toxic drugs. Under certain conditions, the WHO recommends standard regimens lasting 9 to 11 months rather than individual regimens lasting at least 18-20 months. The current study sought to identify factors associated with treatment outcome in RR/MDR-TB patients receiving an injection-based regimen for 9-11 months. This ambispective (prospective and retrospective) observational study was conducted at a tertiary tuberculosis institute in New Delhi, India. Between February 2021 and March 2022, patients with RR/MDR-pulmonary TB who received an injection-based shorter regimen were enrolled. Factors related to treatment outcome were investigated and compared in patients who had a successful outcome versus those who did not. A total of 55 patients were enrolled, with 50.91% being successful (cured/treatment completed) and 49.09% failing (including failure, lost to follow up, death, and regimen changed). The following factors were significantly associated with the unsuccessful outcome, according to univariate analysis: BMI (18.5 kg/m2), anaemia, previous anti-TB treatment, bilateral chest X-ray involvement, and far advanced disease on chest X-ray BMI (18.5 kg/m2), anaemia, and far advanced disease on chest X-ray were all significantly associated with mortality. Anaemia was associated with an unsuccessful outcome (p=0.049) and mortality (p=0.048) in the multiple logistic regression analysis. Early treatment initiation, improved nutrition and anaemia, and regular monitoring can all improve RR/MDR-TB patients' outcomes and prognoses. https://www.monaldi-archives.org/index.php/macd/article/view/2396Multidrug resistant tuberculosisMDR-TB shorter regimenTreatment outcomeMortality |
| spellingShingle | Kiran B Rupak Singla Neeta Singla Vinay V Kuljeet Singh Madhumita Paul Choudhury Nilotpal Bhattacherjee Factors affecting the treatment outcome of injection based shorter MDR-TB regimen at a referral centre in India Monaldi Archives for Chest Disease Multidrug resistant tuberculosis MDR-TB shorter regimen Treatment outcome Mortality |
| title | Factors affecting the treatment outcome of injection based shorter MDR-TB regimen at a referral centre in India |
| title_full | Factors affecting the treatment outcome of injection based shorter MDR-TB regimen at a referral centre in India |
| title_fullStr | Factors affecting the treatment outcome of injection based shorter MDR-TB regimen at a referral centre in India |
| title_full_unstemmed | Factors affecting the treatment outcome of injection based shorter MDR-TB regimen at a referral centre in India |
| title_short | Factors affecting the treatment outcome of injection based shorter MDR-TB regimen at a referral centre in India |
| title_sort | factors affecting the treatment outcome of injection based shorter mdr tb regimen at a referral centre in india |
| topic | Multidrug resistant tuberculosis MDR-TB shorter regimen Treatment outcome Mortality |
| url | https://www.monaldi-archives.org/index.php/macd/article/view/2396 |
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