High effectiveness of a 12-month regimen for MDR-TB patients in Cameroon

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.