Impact of drug resistance on the tuberculosis treatment outcome

Authors

  • E. Lesnic Nicolae Testemiţanu State University of Medicine and Pharmacy Chisinau, the Republic of Moldova,
  • A. Niguleanu Nicolae Testemiţanu State University of Medicine and Pharmacy Chisinau, the Republic of Moldova,
  • A. Ustian Nicolae Testemiţanu State University of Medicine and Pharmacy Chisinau, the Republic of Moldova,
  • L. Todoriko Higher State Education Institution of Ukraine “Bukovinian State Medical University”, Chernivtsi, Ukraine,

DOI:

https://doi.org/10.22141/2312-413x.5.2.2017.105319

Keywords:

multidrug-resistance, multidrug-resistant tuberculosis, risk factors

Abstract

Background. The standard treatment of a new case of multidrug-resistant tuberculosis (MDR-TB) according to WHO recommendations in the Republic of Moldova is performed since 2005 showing a low treatment succes. Actually the treatment success rate increased due to excluding of MDR-TB patients from the general cohort. The major rate of patients with low outcome is represented by the failed and lost to follow-up cases. The purpose of the study was to assess the impact of multidrug-resiatnce and MDR-TB on the tuberculosis treatment outcome. Materials and methods. A retrospective selective, descriptive study targeting social, demographic, economic and epidemiological peculiarities, case-management, diagnostic radiological aspects and microbiological characteristics of 187 patients with pulmonary tuberculosis registered during 2013–2015 distributed in two groups: 1st group (61 patients) with established multidrug-resistant strains using conventional cultural methods and the 2nd group (126 patients) with MDR-TB. Results. Multidrug-resistance was established more frequently in new cases and MDR-TB in two thirds of retreated patients. No difference was identified in gender and age distribution, social, economical, educational characteristics; case-management assessment identified a similar proportion of patients revealed by general practitioners and specialists, with low rate of screened high risk groups. All patients from the multidrug-resistant group began the standard treatment for drug-responsiveness tuberculosis before drug susceptibility testing and one third of MDR-TB group was treated from the onset with the DOTS-Plus regimen. Highest success rate was identified in the new-case subgroups of both groups and higher rate of died patients was determined in the retreated subgroups. Such a low rate of patients aggrevates the resistance. Conclusions. Early diagnosis, drug responsiveness testing and raising awareness among about treatment compliance will improve disease outcome.

References

Raznatovskaja EN, Miлhaшlova AA, Kostenko IA. Efficiency of Genexpert MTB/RIF in Patients with Newly Diagnosed and Recurrent Pulmonary Tuberculosis. Aktual'naja infektologija. 2015;2(7):55-7. (In Russian). doi: 10.22141/2312-413x.2.07.2015.78620.

Fact sheet on tuberculosi 2016. World Health Organization. Available from: http://www.who.int/mediacentre/factsheets/fs104/en/ Accessed: May 13, 2017.

Centrul National de Management in Sănătate. National Centre for Health Management. Chisinau; 2015. Аvailable from: http://www.cnms.md/ Accessed: May 13, 2017.

The global plan to stop TB 2011-2015: transforming the fight towards elimination of tuberculosis.World Health Organization. Geneva; 2011. Available from: http://www.hardydiagnostics.com/wp-content/uploads/2016/04/Global_Plan_2011-2015.pdf Accessed: May 11, 2017.

Global tuberculosis report 2016. World Health Organization. Available from: http://www.who.int/tb/publications/global_report/en/ Accessed: May 15, 2017.

Systematic screening for active tuberculosis. World Health Organization. Geneva; 2013. Available from: http://apps.who.int/iris/bitstream/10665/84971/1/9789241548601_eng.pdf Accessed: May 15, 2017.

Treatment guidelines for drug-resistant tuberculosis 2016. World Health Organization. Available from: http://apps.who.int/iris/bitstream/10665/250125/1/9789241549639-eng.pdf Accessed: May 10, 2017.

End TB Strategy. World Health Organization. Available from: http://www.tbfacts.org/end-tb/ Accessed: May 12, 2017.

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