dc.contributor |
Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia. |
|
dc.creator |
Cox, H |
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dc.creator |
Kalon, S |
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dc.creator |
Allamuratova, S |
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dc.creator |
Sizaire, V |
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dc.creator |
Tigay, Z |
|
dc.creator |
Rüsch-Gerdes, S |
|
dc.creator |
Karimovich, H |
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dc.creator |
Kebede, Y |
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dc.creator |
Mills, C |
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dc.date |
2007 |
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dc.date.accessioned |
2017-01-31T07:10:51Z |
|
dc.date.available |
2017-01-31T07:10:51Z |
|
dc.identifier |
Multidrug-resistant tuberculosis treatment outcomes in Karakalpakstan, Uzbekistan: treatment complexity and XDR-TB among treatment failures. 2007, 2 (11):e1126 PLoS ONE |
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dc.identifier |
1932-6203 |
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dc.identifier |
17987113 |
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dc.identifier |
10.1371/journal.pone.0001126 |
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dc.identifier |
http://hdl.handle.net/10144/26473 |
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dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/26473 |
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dc.identifier |
PLoS One |
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dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/26473 |
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dc.description |
BACKGROUND: A pilot programme to treat multidrug-resistant TB (MDR-TB) was implemented in Karakalpakstan, Uzbekistan in 2003. This region has particularly high levels of MDR-TB, with 13% and 40% among new and previously treated cases, respectively. METHODOLOGY: This study describes the treatment process and outcomes for the first cohort of patients enrolled in the programme, between October 2003 and January 2005. Confirmed MDR-TB cases were treated with an individualised, second-line drug regimen based on drug susceptibility test results, while suspected MDR-TB cases were treated with a standardised regimen pending susceptibility results. PRINCIPAL FINDINGS: Of 108 MDR-TB patients, 87 were started on treatment during the study period. Of these, 33 (38%) were infected with strains resistant to at least one second-line drug at baseline, but none had initial ofloxacin resistance. Treatment was successful for 54 (62%) patients, with 13 (15%) dying during treatment, 12 (14%) defaulting and 8 (8%) failing treatment. Poor clinical condition and baseline second-line resistance contributed to treatment failure or death. Treatment regimens were changed in 71 (82%) patients due to severe adverse events or drug resistance. Adverse events were most commonly attributed to cycloserine, ethionamide and p-aminosalicylic acid. Extensively drug resistant TB (XDR-TB) was found among 4 of the 6 patients who failed treatment and were still alive in November 2006. CONCLUSIONS: While acceptable treatment success was achieved, the complexity of treatment and the development of XDR-TB among treatment failures are important issues to be addressed when considering scaling up MDR-TB treatment. |
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dc.language |
en |
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dc.publisher |
PLoS |
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dc.rights |
Published by Public Library of Science, [url]http://www.plosone.org/[/url]
Archived on this site by Open Access permission |
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dc.title |
Multidrug-resistant tuberculosis treatment outcomes in Karakalpakstan, Uzbekistan: treatment complexity and XDR-TB among treatment failures. |
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