1
|
Maug AKJ, Hossain MA, Gumusboga M, Decroo T, Mulders W, Braet S, Buyze J, Jiménez DA, Schurmans C, Herssens N, Demeulenaere T, Lynen L, de Jong BC, Van Deun A. Finding the right balance between efficacy and tolerability for TB treatment: the search continues. Int J Tuberc Lung Dis 2021; 25:84-86. [PMID: 33384054 DOI: 10.5588/ijtld.20.0575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- A K J Maug
- Damien Foundation Bangladesh, Dhaka, Bangladesh
| | - M A Hossain
- Damien Foundation Bangladesh, Dhaka, Bangladesh
| | - M Gumusboga
- Institute of Tropical Medicine, Antwerp, Belgium
| | - T Decroo
- Institute of Tropical Medicine, Antwerp, Belgium, Research Foundation Flanders, Brussels, Belgium
| | - W Mulders
- Institute of Tropical Medicine, Antwerp, Belgium
| | - S Braet
- Institute of Tropical Medicine, Antwerp, Belgium
| | - J Buyze
- Institute of Tropical Medicine, Antwerp, Belgium
| | - D A Jiménez
- Institute of Tropical Medicine, Antwerp, Belgium
| | - C Schurmans
- Institute of Tropical Medicine, Antwerp, Belgium
| | - N Herssens
- Institute of Tropical Medicine, Antwerp, Belgium
| | | | - L Lynen
- Institute of Tropical Medicine, Antwerp, Belgium
| | - B C de Jong
- Institute of Tropical Medicine, Antwerp, Belgium
| | - A Van Deun
- Independent Consultant, Leuven, Belgium, ,
| |
Collapse
|
2
|
Maug AKJ, Hossain MA, Gumusboga M, Decroo T, Mulders W, Braet S, Buyze J, Arango D, Schurmans C, Herssens N, Demeulenaere T, Lynen L, de Jong BC, Van Deun A. First-line tuberculosis treatment with double-dose rifampicin is well tolerated. Int J Tuberc Lung Dis 2020; 24:499-505. [DOI: 10.5588/ijtld.19.0063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: To compare the occurrence of unfavourable treatment and safety outcomes of double-dose rifampicin (RMP; 20 mg/kg/d, intervention) with standard dose (10 mg/kg/d, control) in a first-line tuberculosis (TB) treatment regimen for smear-positive TB patients in Bangladesh.DESIGN:
This was a randomised clinical trial. The primary efficacy and safety endpoints were the occurrence of an unfavourable treatment outcome (death, failure, relapse or loss to follow-up) and the occurrence of any serious drug-related adverse event (SAE).RESULTS: In primary efficacy
analysis, among 343 control and 347 intervention patients, respectively 15.5% and 11.8% had an unfavourable outcome. In safety analysis, among 349 intervention and 352 control patients, respectively 4.3% and 2.6% experienced an SAE. These differences were not significant. There was a significantly
lower occurrence of SAEs, explained by a lower occurrence of hepatic toxicity, in a RMP double-dosed but erroneously HZE (isoniazid+pyrazinamide+ethambutol) under-dosed subgroup.CONCLUSIONS: Our findings show that there is no statistically significant difference in terms of efficacy
and safety between standard and double-dose RMP. An accidental finding (related to dosage levels of the standard regimen) suggests that high-dose RMP is potentially a lesser cause of hepatotoxicity. Larger trials with more power, or trials with at least a triple-dose might be needed to clearly
see the effect of high-dose RMP on unfavourable outcomes.
Collapse
Affiliation(s)
| | | | | | - T. Decroo
- Institute of Tropical Medicine, Antwerp, Research Foundation Flanders, Brussels
| | | | - S. Braet
- Institute of Tropical Medicine, Antwerp
| | - J. Buyze
- Institute of Tropical Medicine, Antwerp
| | - D. Arango
- Institute of Tropical Medicine, Antwerp
| | | | | | | | - L. Lynen
- Institute of Tropical Medicine, Antwerp
| | | | - A. Van Deun
- Institute of Tropical Medicine, Antwerp, The Union, Paris, France
| |
Collapse
|
3
|
Kehinde AO, Adebiyi EO, Salako AO, Ogunleye VO, Oni AA, Bakare RA, Eltayeb O, Dairo G, Out J, Gehre F, Corrah T, Deun AV, Gumusoboga M, Declercq E, Demeulenaere T, deJong BC, Antonio M. Drug resistance profiles of new- and previously treated patients with pulmonary tuberculosis in Ibadan, Nigeria. Afr J Med Med Sci 2016; 45:67-73. [PMID: 28686829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Information on TB drug resistance profiles and its' associated risk factors are scarce in Nigeria despite the large burden of disease in the country. The study was designed to report drug resistance profiles of new- and previously treated patients with pulmonary tuberculosis (TB) in Ibadan, Nigeria. METHOD Sputum from consenting pulmonary TB patients were collected and cultured for Mycobacterium tuberculosis (Mtb) at the TB laboratory of the University College Hospital, Ibadan, Nigeria using standard method. Mtb were stored and sent for drug susceptibility testing against first and second-line anti-TB drugs at the MRC Unit, The Gambia and at the Institute of Tropical Medicine, Antwerp, Belgium using BACTEC MGIT 960 and proportion method on solid medium respectively. RESULTS Of 238 Mtb collected, 124 (52.1%) were viable, 102 (59.65%) non-viable while 12 (7.02%) were contaminated. About half (58.87%) of the Mtb were from previously treated patients, 40 (32.26%) were from new patients while treatment history of 1.1 (8.87%) were unknown. Forty-seven (37.90%) of the 124 Mtb. tested were multidrug resistant (MDR) out of which, 40 (85.10%) were from previously treated patients.. HIV prevalence was 8.69%. Of the 17 MDR-TB from previously treated cases tested for second-line drugs, four (23.53%) were resistant to fluoroquinolones or injectable agents, 13 (76.47%) were susceptible while none was resistant to both of these classes of drugs. CONCLUSION MDR-TB in Ibadan already demonstrates resistance to second line anti-TB drugs hence management of MDR-TB patients should be strengthened to prevent emergence of extensively drug-resistant TB (XDR-TB).
Collapse
|
4
|
Sawadogo M, Ciza F, Nzeyimana SD, Shingiro A, Ndikumana T, Demeulenaere T, Khogali M, Edginton M, Reid AJ, Kumar AMV, Harries AD. Effect of increased ART-CPT uptake on tuberculosis outcomes and associated factors, Burundi, 2009-2013. Public Health Action 2015; 5:214-6. [PMID: 26767173 DOI: 10.5588/pha.15.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 09/06/2015] [Indexed: 11/10/2022] Open
Abstract
We retrospectively examined 3579 records of human immunodeficiency virus infected tuberculosis (TB) patients diagnosed from January 2009 to June 2013 in 55 TB treatment facilities in Burundi, to demonstrate whether improvement of combined cotrimoxazole preventive therapy and antiretroviral therapy (ART) uptake was accompanied by improvement of treatment outcomes, and to describe associated factors. Treatment success rates increased from 71% to 80% (P < 0.001). While loss to follow-up and transfer-out rates declined significantly, death rates decreased modestly, and remained high, at 14%. ART uptake was worse in suburban areas and private for-profit institutions. World Health Organization targets could be achieved if peripheral health facilities were prioritised.
Collapse
Affiliation(s)
| | - F Ciza
- National Tuberculosis Control Programme, Ministry of Health, Bujumbura, Burundi
| | - S D Nzeyimana
- National Tuberculosis Control Programme, Ministry of Health, Bujumbura, Burundi
| | - A Shingiro
- National Antituberculosis Centre, Bujumbura, Burundi
| | - T Ndikumana
- National Tuberculosis Control Programme, Ministry of Health, Bujumbura, Burundi
| | | | - M Khogali
- Médecins Sans Frontières, Operational Research Unit, Operational Centre Brussels, Luxembourg
| | - M Edginton
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; School of Public Health, Faculty of Health Sciences, University of Witwaterstand, Johannesburg, South Africa
| | - A J Reid
- Médecins Sans Frontières, Operational Research Unit, Operational Centre Brussels, Luxembourg
| | - A M V Kumar
- The Union, South-East Asia Regional Office, New Delhi, India
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
5
|
Kimerling ME, Kluge H, Vezhnina N, Iacovazzi T, Demeulenaere T, Portaels F, Matthys F. Inadequacy of the current WHO re-treatment regimen in a central Siberian prison: treatment failure and MDR-TB. Int J Tuberc Lung Dis 1999; 3:451-3. [PMID: 10331736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Multidrug-resistant tuberculosis (MDR-TB) threatens the progress of global control efforts. Prisons represent a high risk setting for development and transmission of MDR-TB. In a Siberian TB referral prison (Kemerovo region), the treatment failure rate is 35% (June 1996-March 1997), despite implementation of a strict DOTS program and use of the World Health Organization Category 2 re-treatment regimen for all new cases. Among 164 patients (December 1997-March 1998), initial resistance to isoniazid and rifampin is 22.6%. Such a rate is a warning call to reconsider prison control strategies, and importantly, to address the treatment regimens necessary to combat an institutional epidemic of MDR-TB.
Collapse
Affiliation(s)
- M E Kimerling
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, USA.
| | | | | | | | | | | | | |
Collapse
|
6
|
Colebunders R, Kintin D, Fleerackers Y, Demeulenaere T, Vandenbruaene M, Goeman J, Kestens L, Farber CM, Soete F. Surveillance case definition for AIDS in resource-poor countries. Lancet 1993; 342:864-5. [PMID: 8104289 DOI: 10.1016/0140-6736(93)92723-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|