High Effectiveness of a 12-month Regimen for MDR-TB Patients in Cameroon

Int J Tuberc Lung Dis. 2015 May;19(5):517-24. doi: 10.5588/ijtld.14.0535.

Abstract

Setting: Two specialised multidrug-resistant tuberculosis (MDR-TB) treatment units in Cameroon.

Objective: To assess outcome and adverse drug events with a standardised 12-month regimen for MDR-TB among second-line drug naïve patients.

Design: Prospective observational study of MDR-TB patients treated with a standardised 12-month regimen including gatifloxacin, clofazimine, prothionamide, ethambutol and pyrazinamide throughout, supplemented by kanamycin and isoniazid during an intensive phase of a minimum of 4 months. Progress was monitored monthly until treatment completion and twice over one year after treatment cessation.

Results: Eighty-seven potentially eligible patients were lost and never treated due to delayed availability of test results. Among the 150/236 eligible and treated patients, 134 (89%) successfully completed treatment, 10 died, 5 were lost, 1 failed and none relapsed. The patients' mean age was 33.7 years (range 17-68), 73 (49%) were females, 120 (80%) had failed on previous treatment, 30 (20%) were human immunodeficiency virus seropositive, 62 (43%) had a body mass index <18.5 kg/m(2) and 41 (27%) had radiographic involvement of five or six of the six lung zones. The most important adverse drug event was hearing impairment, which occurred in 46 of 106 (43%) patients.

Conclusions: These results add further evidence for the usefulness of shorter, standardised regimens among patients without second-line drug resistance.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / adverse effects*
  • Antitubercular Agents / therapeutic use*
  • Cameroon
  • Clofazimine / therapeutic use
  • Cohort Studies
  • Confidence Intervals
  • Developing Countries
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Ethambutol / therapeutic use
  • Female
  • Fluoroquinolones / therapeutic use
  • Gatifloxacin
  • Humans
  • Isoniazid / therapeutic use
  • Kanamycin / therapeutic use
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Prothionamide / therapeutic use
  • Pyrazinamide / therapeutic use
  • Risk Assessment
  • Time Factors
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / diagnosis
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Young Adult

Substances

  • Antitubercular Agents
  • Fluoroquinolones
  • Pyrazinamide
  • Kanamycin
  • Prothionamide
  • Ethambutol
  • Clofazimine
  • Gatifloxacin
  • Isoniazid