Factors affecting outcome of longer regimen multidrug-resistant tuberculosis treatment in West Java Indonesia: A retrospective cohort study

Soeroto, Arto Yuwono; Pratiwi, Chica; Santoso, Prayudi; Lestari, Bony Wiem

doi:10.1371/journal.pone.0246284

Cited by 34 publications

(29 citation statements)

References 39 publications

(34 reference statements)

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“…A previous study investigating longer regimen in MDR/ RR-TB patients in Indonesia showed a 50% successful outcome rate. Age, gender, BMI, previous TB treatment, time of culture conversion, acid-fast bacilli (AFB) smear, HIV, chronic kidney disease (CKD), and cavities on chest radiograph were the predictors of the longer regimen outcome [19]. In this paper, we discovered that the shorter regimen for MDR/RR-TB treatment appears to have a better outcome with success rate of 65%, which was higher than the longer regimen from the same setting [19].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with treatment outcome of MDR/RR-TB patients treated with shorter injectable based regimen in West Java Indonesia

et al. 2022

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Background and aims Multi drug or rifampicin resistant tuberculosis (MDR/RR-TB) is a major burden to TB prevention and eradication globally. Since 2016, WHO guidelines have included options for treating MDR/RR-TB with a standard regimen of 9 to 11 months duration (the ’shorter regimen’) rather than an individual regimen of at least 20 months. This regimen has been introduced in Indonesia since September 2017. Therefore, we aimed to determine the success rate and factors associated with the treatment outcome of shorter injectable based regimen in West Java province, Indonesia. Methods This was a retrospective cohort study of MDR/RR-TB patients aged over 18 years old who received the shorter injectable based regimen between September 2017 and December 2020. We defined successful outcomes as the combined proportion of patients who were cured or had complete treatment. While, unsuccessful outcomes were defined as the combined proportion of patients who died from any causes, failure, and loss to follow-up (LTFU). Results A total of 315 patients were included in this study. The success rate was 64.5%. Multivariate analysis showed male gender (aRR = 1.18, 95% CI 1.04 to 1.34) increased the chance of successful outcome, while malnutrition (aRR = 0.78, 95% CI 0.68 to 0.89), history of previous TB treatment (aRR = 0.80%CI 0.68 to 0.94), and time of culture conversion >2 months (aRR = 0.72 (95% CI 0.59 to 0.87) decreased the chance of successful outcome. Conclusion History of previous TB treatment, time of culture conversion >2 months, and malnutrition were independent factors that decrease the chance for success rate, while male gender increase the likelihood for success rate of patients treated by the shorter injectable based regimen.

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Section: Discussionmentioning

confidence: 99%

Factors associated with treatment outcome of MDR/RR-TB patients treated with shorter injectable based regimen in West Java Indonesia

et al. 2022

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“…55 However, it is higher than that reported by WHO (57%) in 2017, 56 a meta-analysis (61%) 57 and an Indonesian national (48%) as well as provincial (36%) study. 58 LPA results revealed that 11.3% of the clinical isolates were resistant to FQs, whereas 3.8% were resistant to both FQs and injectable TB drugs. This is much higher than reported recently from a national study (3.4%).…”

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confidence: 98%

Explorative Analysis of Treatment Outcomes of Levofloxacin- and Moxifloxacin-Based Regimens and Outcome Predictors in Ethiopian MDR-TB Patients: A Prospective Observational Cohort Study

Sidamo¹,

Shibeshi²,

Yimer³

et al. 2021

IDR

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Purpose/Background: Although Ethiopia is among the thirty high multi-drug resistant tuberculosis (MDR-TB) burden countries in the world, comparative therapeutic efficacy of moxifloxacin and levofloxacin has not been explored, particularly in MDR-TB patients. We therefore aimed to prospectively compare clinical outcomes and determine potential predictors of the outcomes among patients on moxifloxacin or levofloxacin-based MDR-TB drug regimens. Methods: We analyzed clinical parameters and laboratory data of eighty MDR-TB patients on moxifloxacin-or levofloxacin-based regimens. The clinical outcomes were compared using the Kaplan-Meier survival functions and the outcome definitions of the 2013 World Health Organization. Monthly sputum culture conversions and a molecular line probe assay results were also assessed. Observed outcomes and patient-related variables between the two groups were compared using chi-square, Wilcoxon Rank and Fisher exact tests. We also determined the potential predictors influencing treatment outcomes of moxifloxacin and levofloxacin using Cox proportional hazard model. Results:The levofloxacin-based treatment group had a lower failure rate and adverse drug events as well as better treatment success than the moxifloxacin-based group. Overall treatment success was 65%. Disaggregating the data revealed that 53.8% were cured, 11.2% completed treatment, 10.0% died, 11.2% failed, and 13.8% were lost-to-follow-up. The line probe assay result showed that 11.3% of the clinical isolates were resistant to fluoroquinolones and 3.8% were resistant to both fluoroquinolones and injectable anti-TB agents. Treatment regimen type, culture conversion rate, alcohol use, cavity lesion, serum levels of creatinine and alanine aminotransferase were independent predictors of treatment outcome. Conclusion:The levofloxacin-based regimen group has a better overall treatment success than the moxifloxacin-based group among MDR-TB patients. Clinical parameters and substance use history of the patients influenced treatment outcomes. We recommend further broader clinical studies to substantiate our findings as an input to review MDR-TB treatment guidelines.

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“…The effectiveness of second-line anti TB drugs in MDR-TB patients is best evaluated in the first eight weeks of administration. 13 The TB and DM interactions potentially cause adverse impact by increasing each other's complications, making diagnosis and treatment more difficult, worsening disease course and outcome. 14 Current TB treatment and control levels in the public sector have led to lower levels of MDR TB prevalence than if TB treatment had been provided exclusively by private-sector clinics that do not follow effective TB treatment protocols.…”

Section: Resultsmentioning

confidence: 99%

Multi drugs resistance to Diabetes Mellitus patients with tuberculosis in Manado City

Rambi¹,

Sukandar

Makalew

et al. 2021

J. Teknol. Laboratorium

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Diabetes mellitus (DM) with pulmonary tuberculosis (TB) is an infectious disease if not educated regularly, there will be a high risk of drug resistance and even some anti-tuberculosis drugs. This study aims to identify anti-tuberculosis drug resistance in DM patients with TB in Manado City. The population in the study types 2 DM patients as amount 80 patients. Based on TCM/GenExpert examination from 47 respondents, there were 17 respondents positive multi drugs resistance rifampicin (RR). Sampling taking based on inclusion criteria, i.e., have had type DM for five years, had suffered TB MDR RR based on GenXpert examination as much as 17 respondents followed in the resistance test with Sputum TB culture and MGIT method. The result of the study showed that MDR DM-TB with MGIT method as followed is obtained from 17 samples, six samples (35.30%) resistance INH 0.4 mg and 1 sample (5.88%) MDR canamycin, and still sensitive INH 0.4 mg and camaycin is ten samples (58.82%). This study results could be used to program planning of prevention and controlling efforts TB-DM in this treatment obedience and regimen anti-tuberculosis medicine for MDR-TB patients.

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Factors affecting outcome of longer regimen multidrug-resistant tuberculosis treatment in West Java Indonesia: A retrospective cohort study

Cited by 34 publications

References 39 publications

Factors associated with treatment outcome of MDR/RR-TB patients treated with shorter injectable based regimen in West Java Indonesia

Factors associated with treatment outcome of MDR/RR-TB patients treated with shorter injectable based regimen in West Java Indonesia

Explorative Analysis of Treatment Outcomes of Levofloxacin- and Moxifloxacin-Based Regimens and Outcome Predictors in Ethiopian MDR-TB Patients: A Prospective Observational Cohort Study

Multi drugs resistance to Diabetes Mellitus patients with tuberculosis in Manado City

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