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Multidrug-resistant tuberculosis treatment outcomes in Karakalpakstan, Uzbekistan: treatment complexity and XDR-TB among treatment failures.

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dc.contributor Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia.
dc.creator Cox, H
dc.creator Kalon, S
dc.creator Allamuratova, S
dc.creator Sizaire, V
dc.creator Tigay, Z
dc.creator Rüsch-Gerdes, S
dc.creator Karimovich, H
dc.creator Kebede, Y
dc.creator Mills, C
dc.date 2007
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
dc.identifier 1932-6203
dc.identifier 17987113
dc.identifier 10.1371/journal.pone.0001126
dc.identifier http://hdl.handle.net/10144/26473
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/26473
dc.identifier PLoS One
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/26473
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.
dc.language en
dc.publisher PLoS
dc.rights Published by Public Library of Science, [url]http://www.plosone.org/[/url] Archived on this site by Open Access permission
dc.title Multidrug-resistant tuberculosis treatment outcomes in Karakalpakstan, Uzbekistan: treatment complexity and XDR-TB among treatment failures.


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