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. 2019 Sep;101(3):502-509.
doi: 10.4269/ajtmh.19-0175.

Treatment Outcomes and Adverse Events from a Standardized Multidrug-Resistant Tuberculosis Regimen in a Rural Setting in Angola

María Luisa Aznar  1   2 , Ariadna Rando Segura  3 , María Milagros Moreno  2 , Mateu Espasa  3 , Elena Sulleiro  3 , Cristina Bocanegra  2   1 , Eva Gil Olivas  2 , Arlete Nindia Eugénio  2 , Adriano Zacarias  2 , Domingos Katimba  2 , Estevao Gabriel  2 , Jacobo Mendioroz  4 , Maria Teresa López García  2 , Tomas Pumarola  3 , María Teresa Tórtola  3 , Israel Molina  1
Affiliations

Treatment Outcomes and Adverse Events from a Standardized Multidrug-Resistant Tuberculosis Regimen in a Rural Setting in Angola

María Luisa Aznar et al. Am J Trop Med Hyg. 2019 Sep.

Abstract

Treatment for multidrug-resistant tuberculosis (MDR TB) is associated with adverse events (AE). Patients treated with an MDR TB regimen in Hospital Nossa Senhora da Paz, Cubal, Angola, were prospectively enrolled from May 2013 to July 2015. Baseline characteristics, AE, and clinical and microbiological outcomes were recorded. A total of 216 patients were treated with an MDR TB regimen and 179 (82.9%) patients developed at least one AE. The most common AE were elevation of liver enzymes (46.8% of patients), elevated creatinine (44.4% of patients), and ototoxicity (40.7% of patients). Previous TB treatment was associated with the occurrence of AE (OR 4.89, 95% CI: 2.09-11.46, P < 0.001) and months on treatment was associated to severe AE (OR 1.11 95% CI: 1.04-1.18, P = 0.001). Successful treatment was achieved in 117 (54.2%) patients. Incidence of AE was associated with an unsuccessful outcome (OR 1.23, 95% CI: 1.09-1.40, P = 0.001). Patients treated with MDR TB treatment frequently experience AE, and these are related with previous TB treatment and duration of treatment. Given the high percentage of patients experiencing AE and the low treatment success rates, more effective and less toxic drugs to treat MDR TB are urgently needed.

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Figures

Figure 1.
Figure 1.
Culture results of patients initiated on multidrug-resistant tuberculosis treatment based on Xpert MTB/RIF results and clinical approach.
Figure 2.
Figure 2.
Cumulative adverse events experienced during the follow-up period. This figure appears in color at www.ajtmh.org.
See this image and copyright information in PMC

References

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