Short-course treatment outcomes and adverse events in adults and children-adolescents with MDR-TB in Niger

SETTING: Niger National Tuberculosis Programme.OBJECTIVE: To describe the outcomes and adverse events (AEs) in a cohort of adults, children and adolescents with multidrug-resistant tuberculosis (MDR-TB) who were treated with the 'short-course regimen'.DESIGN: The regimen comprised an inten...

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Bibliographic Details
Published in:	The international journal of tuberculosis and lung disease Vol. 23; no. 5; pp. 625 - 630
Main Authors:	Harouna, S. H., Ortuno-Gutierrez, N., Souleymane, M. B., Kizito, W., Morou, S., Boukary, I., Zolfo, M., Benedetti, G., Piubello, A.
Format:	Journal Article
Language:	English
Published:	France International Union Against Tuberculosis and Lung Disease 01-05-2019 International Union against Tuberculosis and Lung Disease (IUATLD)
Subjects:	Adolescent Adolescents Adult Adults Aged Antitubercular Agents - administration & dosage Antitubercular Agents - adverse effects Child Children Children/adolescent Clofazimine Cohort Studies Drug Administration Schedule Drug Therapy, Combination Ethambutol Female Fluoroquinolones Gatifloxacin Hepatotoxicity Humans Isoniazid Kanamycin Male Mdr-Tb Middle Aged Multidrug resistance Multidrug resistant organisms National Health Programs Niger Ototoxicity Pyrazinamide Retrospective Studies Short-Course Statistical analysis Teenagers Time Factors Treatment Outcome Tuberculosis Tuberculosis, Multidrug-Resistant - drug therapy Vomiting Young Adult Niger
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Summary:	SETTING: Niger National Tuberculosis Programme.OBJECTIVE: To describe the outcomes and adverse events (AEs) in a cohort of adults, children and adolescents with multidrug-resistant tuberculosis (MDR-TB) who were treated with the 'short-course regimen'.DESIGN: The regimen comprised an intensive phase of 4-6 months with kanamycin, medium-high dose of isoniazid and prothionamide, and high doses of gatifloxacin, clofazimine, ethambutol and pyrazinamide throughout. Sixty-five patients were treated with a regimen of 12-14 months and 55 patients with a regimen of 9-11 months.RESULTS: Of the 120 patients evaluated, 110 (92%) were adults (median age 31 years) and 10 (8%) were children or adolescents (median age 17 years). The treatment success rate was respectively 88% and 83% with the 9-month regimen, and 90% and 75% with the 12-month regimen in adults and children/adolescents. Initial resistance to ethambutol and prothionamide did not affect treatment success rates but resistance to fluoroquinolones did, although this was not statistically significant. Vomiting was the most frequently encountered AE, followed by ototoxicity and hepatotoxicity. AEs experienced were mild or moderate in severity in most patients, and did not lead to treatment interruption.CONCLUSION: These results confirm the programmatic effectiveness and tolerability of the shorter regimen in second-line drug-naïve patients.
Bibliography:	1027-3719(20190501)23:5L.625;1- (R) Medicine - General ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1027-3719 1815-7920
DOI:	10.5588/ijtld.17.0871