TITLE

Effectiveness of a Government-Organized and Hospital-Initiated Treatment for Multidrug-Resistant Tuberculosis Patients-A Retrospective Cohort Study

AUTHOR(S)
Chan, Pei-Chun; Huang, Su-Hua; Yu, Ming-Chih; Lee, Shih-Wei; Huang, Yi-Wen; Chien, Shun-Tien; Lee, Jen-Jyh
PUB. DATE
February 2013
SOURCE
PLoS ONE;Feb2013, Vol. 8 Issue 2, p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: In contrast to the conventional model of hospital-treated and government directly observed treatment (DOT) for multidrug-resistant tuberculosis (MDR-TB) patient care, the Taiwan MDR-TB Consortium (TMTC) was launched in May 2007 with the collaboration of five medical care groups that have provided both care and DOT. This study aimed to determine whether the TMTC provided a better care model for MDR-TB patients than the conventional model. Methods and Findings: A total of 651 pulmonary MDR-TB patients that were diagnosed nation-wide from January 2000-August 2008 were enrolled. Of those, 290 (45%) MDR-TB patients whose initial sputum sample was taken in January 2007 or later were classified as patients in the TMTC era. All others were classified as patients in the pre-TMTC era. The treatment success rate at 36 months was better in the TMTC era group (82%) than in the pre-TMTC era group (61%) (p<0.001). With multiple logistic regressions, diagnosis in the TMTC era (adjusted odds ratio (aOR) 2.8, 95% confidence interval (CI) 1.9–4.2) was an independent predictor of a higher treatment success rate at 36 months. With the time-dependent proportional hazards method, a higher treatment success rate was still observed in the TMTC era group compared to the pre-TMTC era group (adjusted hazard ratio 6.3, 95% CI 4.2–9.5). Conclusion: The improved treatment success observed in the TMTC era compared to the pre-TMTC era is encouraging. The detailed TMTC components that contribute the most to the improved outcome will need confirmation in follow-up studies with large numbers of MDR-TB patients.
ACCESSION #
87625622

 

Related Articles

  • Risk Factors for Poor Treatment Outcomes in Patients with MDR-TB and XDR-TB in China: Retrospective Multi-Center Investigation. Tang, Shenjie; Tan, Shouyong; Yao, Lan; Li, Fujian; Li, Li; Guo, Xinzhi; Liu, Yidian; Hao, Xiaohui; Li, Yanqiong; Ding, Xiuxiu; Zhang, Zhanjun; Tong, Li; Huang, Jianan // PLoS ONE;Dec2013, Vol. 8 Issue 12, p1 

    Background:The treatment of patients with MDR- and XDR-TB is usually more complex, toxic and costly and less effective than treatment of other forms of TB. However, there is little information available on risk factors for poor outcomes in patients with MDR- and XDR-TB in China....

  • Predictors of Two Months Culture Conversion in Multidrug-Resistant Tuberculosis: Findings from a Retrospective Cohort Study. Basit, Anila; Ahmad, Nafees; Khan, Amer Hayat; Javaid, Arshad; Syed Sulaiman, Syed Azhar; Afridi, Afsar Khan; Adnan, Azreen Syazril; Haq, Israr ul; Shah, Syed Saleem; Ahadi, Ahmed; Ahmad, Izaz // PLoS ONE;Apr2014, Vol. 9 Issue 4, p1 

    Background: Various studies have reported culture conversion at two months as a predictor of successful treatment outcome in multidrug-resistant tuberculosis (MDR-TB). Objectives: The present study was conducted with the aim to evaluate the rate and predictors of culture conversion at two months...

  • Improvement in Plasma Drug Activity during the Early Treatment Interval among Tanzanian Patients with Multidrug-Resistant Tuberculosis. Ndusilo, Norah D.; Heysell, Scott K.; Mpagama, Stellah G.; Gratz, Jean; Segesela, Farida H.; Pazia, Saumu J.; Wang, Xin-Qun; Houpt, Eric R.; Kibiki, Gibson S. // PLoS ONE;Mar2015, Vol. 10 Issue 3, p1 

    Background: Individual pharmacokinetic variability may be common in patients treated for multidrug-resistant tuberculosis (MDR-TB) but data are sparse from resource-limited settings and across the early treatment interval. Methods: Plasma drug activity, as measured by the TB Drug Activity...

  • Treatment Outcomes of Isoniazid- Resistant Tuberculosis Patients, Western Cape Province, South Africa. Jacobson, Karen R.; Theron, Danie; Victor,3, Thomas C.; Streicher, Elizabeth M.; Warren, Robin M.; Murray, Megan B. // Clinical Infectious Diseases;8/15/2011, Vol. 53 Issue 4, p369 

    We report treatment outcomes from a retrospective cohort of patients with isoniazid-monoresistant tuberculosis in rural South Africa. Sixteen percent of patients had poor outcomes, 61% of whom progressed to multidrug-resistant tuberculosis. These data reveal the need for early identification and...

  • Specific gyrA gene mutations predict poor treatment outcome in MDR-TB. Rigouts, L.; Coeck, N.; Gumusboga, M.; de Rijk, W. B.; Aung, K. J. M.; Hossain, M. A.; Fissette, K.; Rieder, H. L.; Meehan, C. J.; de Jong, B. C.; Van Deun, A. // Journal of Antimicrobial Chemotherapy (JAC);Feb2016, Vol. 71 Issue 2, p314 

    Objectives: Mutations in the gyrase genes cause fluoroquinolone resistance in Mycobacterium tuberculosis. However, the predictive value of these markers for clinical outcomes in patients with MDR-TB is unknown to date. The objective of this study was to determine molecular markers and...

  • Patients flee, drawing attention to quarantine dilemma. Opar, Alisa // Nature Medicine;Feb2008, Vol. 14 Issue 2, p109 

    The article discusses the quarantine dilemma raised by an incident in South Africa where 49 patients with highly infectious, drug-resistant tuberculosis, fled the Jose Pearson Hospital near Port Elizabeth. Key challenges of mandatory isolation include determining when and how people should be...

  • TB traveler questioning quarantine.  // MLO: Medical Laboratory Observer;Sep2007, Vol. 39 Issue 9, p8 

    The article reports on the issues concerning the speaking out of attorney Andrew Speaker due to his forced detainment at the National Jewish Memorial Hospital in the U.S. Speaker was quarantined due to the allegations that he was carrying an extensively drug-resistant tuberculosis (XDR-TB)....

  • Patterns of Treatment Interruption among Patients with Multidrug-Resistant TB (MDR TB) and Association with Interim and Final Treatment Outcomes. Podewils, Laura Jean; Gler, Maria Tarcela S.; Quelapio, Maria Imelda; Chen, Michael P. // PLoS ONE;Jul2013, Vol. 8 Issue 7, p1 

    Background: The reasons that patients with multidrug-resistant tuberculosis (MDR TB) miss treatment are multi-factorial and complex. Identifying patterns of treatment interruption that predict poor outcomes can be used to target program activities aiming to improve treatment adherence....

  • Risk Factors for Multidrug-Resistant Tuberculosis among Patients with Pulmonary Tuberculosis at the Central Chest Institute of Thailand. Chuchottaworn, Charoen; Thanachartwet, Vipa; Sangsayunh, Piamlarp; Than, Thu Zar Myint; Sahassananda, Duangjai; Surabotsophon, Manoon; Desakorn, Varunee // PLoS ONE;10/7/2015, Vol. 10 Issue 10, p1 

    There are limited data available on the risk factors for multidrug-resistant tuberculosis (MDR-TB). Therefore, we here conducted a retrospective matched case−control study among adults with pulmonary TB who received treatment at the Central Chest Institute of Thailand (CCIT) between...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics