Survival of patients with multidrug-resistant TB in Eastern Europe: what makes a difference?

Balabanova, Yanina; Ignatyeva, Olga; Fiebig, Lena; Riekstiņa, Vija; Danilovitš, Manfred; Jaama, Kadri; Davidavičienė, Edita; Radiulyte, Birute; Popa, Christina; Nikolayevskyy, Vladyslav; Drobniewski, Francis

doi:10.1136/thoraxjnl-2015-207638

Cited by 28 publications

(40 citation statements)

References 29 publications

(33 reference statements)

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“…In this study, the incidence of mortality was 7.42 (95% CI: 5.56, 9.91) /100 PY follow-up during treatment and most patients died early on the initiation of treatment. This finding accords with earlier reports from Ethiopia [13,14] but our incidence was considerably higher than that found in Eastern Europe (1.094/100 PY) [15]. This might be due to the early detection of TB cases in Europe (46%), than in Ethiopia ( 8.6%).…”

Section: Discussionsupporting

confidence: 92%

Predictors of mortality among multidrug-resistant tuberculosis patients in central Ethiopia: a retrospective follow-up study

et al. 2020

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The burden of multidrug-resistant tuberculosis (MDR-TB) related to mortality in resource-poor countries remains high. This study aimed to estimate the incidence and predictors of death among MDR-TB patients in central Ethiopia. A retrospective follow-up study was conducted at three hospitals in the Amhara region on 451 patients receiving treatment for MDR-TB from September 2010 to January 2017. Data were collected from patient registration books, charts and computer databases. Data were fitted to a parametric frailty model and survival was expressed as an adjusted hazard ratio (AHR) with a 95% confidence interval (CI). The median follow-up time of participants was 20 months (interquartile range: 12, 22) and 46 (10.20%) of patients died during this period. The incidence rate of mortality was 7.42 (95% CI 5.56–9.91)/100 person-years. Older age (AHR = 1.04, 95% CI 1.01–1.08), inability to self-care (AHR = 13.71, 95% CI 5.46–34.40), co-morbidity (AHR = 5.74, 95% CI 2.19–15.08), low body mass index (AHR = 4.13, 95% CI 1.02–16.64), acute lung complications (AHR = 4.22, 95% CI 1.66–10.70) and lung consolidation at baseline (AHR = 5.27, 95% CI 1.06–26.18) were independent predictors of mortality. Most of the identified predictor factors of death in this study were considered to be avoidable if the TB programme had provided nutritional support for malnourished patients and ensured a close follow-up of the elderly, and patients with co-morbidities.

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Section: Discussionsupporting

confidence: 92%

Predictors of mortality among multidrug-resistant tuberculosis patients in central Ethiopia: a retrospective follow-up study

et al. 2020

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“…Currently, the World Health Organization (WHO) recommends a therapy duration for M/XDR-TB patients of at least 20 months unless specific criteria allow for a standardized short course MDR-TB regimen over 9-12 months (3,(9)(10)(11)(12)(13). Only approximately 50% of M/XDR-TB patients in Europe attain favorable outcomes.…”

Section: Introductionmentioning

confidence: 99%

Treatment responses in multidrug-resistant tuberculosis in Germany

Heyckendorf

Leth

Avsar

et al. 2018

int j tuberc lung dis

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“…The World Health Organization (WHO) estimates that 9.6 million people worldwide fell ill with TB in 2014, of those ca 480,000 cases with MDR-TB [1]. Where second-line drug susceptibility testing (DST) is available, (pre)XDR-TB is frequently detected [2,3]. These patients have a high risk of death [3].…”

Section: Introductionmentioning

confidence: 99%

“…Where second-line drug susceptibility testing (DST) is available, (pre)XDR-TB is frequently detected [2,3]. These patients have a high risk of death [3]. …”

Section: Introductionmentioning

confidence: 99%

A joint cross-border investigation of a cluster of multidrug-resistant tuberculosis in Austria, Romania and Germany in 2014 using classic, genotyping and whole genome sequencing methods: lessons learnt

et al. 2017

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Molecular surveillance of multidrug-resistant tuberculosis (MDR-TB) using 24-loci MIRU-VNTR in the European Union suggests the occurrence of international transmission. In early 2014, Austria detected a molecular MDR-TB cluster of five isolates. Links to Romania and Germany prompted the three countries to investigate possible cross-border MDR-TB transmission jointly. We searched genotyping databases, genotyped additional isolates from Romania, used whole genome sequencing (WGS) to infer putative transmission links, and investigated pairwise epidemiological links and patient mobility. Ten isolates from 10 patients shared the same 24-loci MIRU-VNTR pattern. Within this cluster, WGS defined two subgroups of four patients each. The first comprised an MDR-TB patient from Romania who had sought medical care in Austria and two patients from Austria. The second comprised patients, two of them epidemiologically linked, who lived in three different countries but had the same city of provenance in Romania. Our findings strongly suggested that the two cases in Austrian citizens resulted from a newly introduced MDR-TB strain, followed by domestic transmission. For the other cases, transmission probably occurred in the same city of provenance. To prevent further MDR-TB transmission, we need to ensure universal access to early and adequate therapy and collaborate closely in tuberculosis care beyond administrative borders.

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Survival of patients with multidrug-resistant TB in Eastern Europe: what makes a difference?

Cited by 28 publications

References 29 publications

Predictors of mortality among multidrug-resistant tuberculosis patients in central Ethiopia: a retrospective follow-up study

Predictors of mortality among multidrug-resistant tuberculosis patients in central Ethiopia: a retrospective follow-up study

Treatment responses in multidrug-resistant tuberculosis in Germany

A joint cross-border investigation of a cluster of multidrug-resistant tuberculosis in Austria, Romania and Germany in 2014 using classic, genotyping and whole genome sequencing methods: lessons learnt

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