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Journal Article
|Research

A 10-year review of isoniazid-resistant TB management in Uzbekistan 2009-2020

Rekart M, Thit P, Oluya M, Moe S, Hasan T, Parpieva N, Safaev K, Khristusev A, Zinaida T, Singh J, Allamuratova S, Azamat I, Restrepo C, Sitali N, Achar J, Alvaraez J, Sinha A
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A 10-year review of isoniazid-resistant TB management in Uzbekistan 2009-2020 | Journal Article / Research | MSF Science Portal
Abstract

Background

Isoniazid (INH, H) resistance is the most common drug-resistant TB pattern, with treatment success rates lower than those in drug-susceptible TB. The WHO recommends a 6-month regimen of rifampicin (RIF, R), ethambutol (EMB, E), pyrazinamide (PZA, Z), and levofloxacin (Lfx) (6REZLfx) for INH-resistant, RIF-susceptible TB (HRRS-TB). Uzbekistan has a high burden of TB (62/100,000 population) and multidrug-resistant TB (12/100,000 population).


Methods

We conducted a retrospective, descriptive study of microbiologically confirmed HRRS-TB using routinely collected programmatic data from 2009 to 2020.


Results

We included 854 HRRS-TB cases. Treatment success was 80.2% overall. For REZLfx, the treatment success rate was 92.0% over a short treatment duration, with no amplifications to RIF or second-line anti-TB drug resistance. We documented 46 regimens with REZLfx plus linezolid (success 87.0%) and 539 regimens using kanamycin or capreomycin (success 76.6%). We identified 37 treatment failures (4.3%), 30 deaths (3.5%), 25 resistance amplifications (2.9%), including eight to RIF (0.9%), and 99 lost to follow-up (LTFU) cases (11.6%). Unsuccessful outcomes were more common with older age, diabetes, chest X-ray cavities, smear positivity, smear-positive persistence, and male sex. LTFU was more common with injection-containing regimens.


Conclusions

REZLfx is a safe and effective first-line treatment for INH-resistant, RIF-susceptible TB. Treatment success was lower and LTFU was higher for injection-containing regimens.

Countries

Uzbekistan

Subject Area

tuberculosisantimicrobial resistance

Languages

English
DOI
10.5588/ijtldopen.23.0533
Published Date
01 Jul 2024
PubMed ID
39035427
Journal
IJTLD OPEN
Volume | Issue | Pages
Volume 1, Issue 7, Pages 285-291
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