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. 2014 Aug;18(8):912-8.
doi: 10.5588/ijtld.13.0028.

Treatment for LTBI in contacts of MDR-TB patients, Federated States of Micronesia, 2009-2012

S Bamrah  1 , R Brostrom  1 , F Dorina  2 , L Setik  2 , R Song  1 , L M Kawamura  3 , A Heetderks  1 , S Mase  1
Affiliations

Treatment for LTBI in contacts of MDR-TB patients, Federated States of Micronesia, 2009-2012

S Bamrah et al. Int J Tuberc Lung Dis. 2014 Aug.

Abstract

Setting: Few studies have shown the operational feasibility, safety, tolerability, or outcomes of multidrug-resistant latent tuberculous infection (MDR LTBI) treatment. After two simultaneous multidrug-resistant tuberculosis (MDR-TB) outbreaks in Chuuk, Federated States of Micronesia, infected contacts were offered a 12-month fluoroquinolone (FQ) based MDR LTBI treatment regimen.

Design: Between January 2009 and February 2012, 119 contacts of MDR-TB patients were followed using a prospective observational study design. After MDR-TB disease was excluded, 12 months of daily FQ-based preventive treatment of MDR LTBI was provided by directly observed therapy.

Results: Among the 119 infected contacts, 15 refused, while 104 began treatment for MDR LTBI. Of the 104 who initiated treatment, 93 (89%) completed treatment, while 4 contacts discontinued due to adverse effects. None of the 104 contacts who undertook MDR LTBI treatment of any duration developed MDR-TB disease; however, 3 of 15 contacts who refused and 15 unidentified contacts developed MDR-TB disease.

Conclusion: Providing treatment for MDR LTBI can be accomplished in a resource-limited setting, and contributed to preventing MDR-TB disease. The Chuuk TB program implemented treatment of MDR LTBI with an 89% completion rate. The MDR LTBI regimens were safe and well tolerated, and no TB cases occurred among persons treated for MDR LTBI.

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Conflict of interest statement

Conflict of interest: none declared.

Figures

Figure 1
Figure 1
Flow diagram of screening and results of investigation, Chuuk, Federated States of Micronesia, 2009–2012. MDR-TB = multidrug-resistant TB; TB = tuberculosis; TST = tuberculin skin test: LTBI = latent tuberculous infection.
Figure 2
Figure 2
MDR-TB outbreak cases (n =36), Chuuk, Federated States of Micronesia, 2009–2012. MDR-TB = multidrug-resistant tuberculosis.
See this image and copyright information in PMC

Comment in

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