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Journal Article
|Research

How do patients who fail first-line TB treatment but who are not placed on an MDR-TB regimen fare in South India?

Nagaraka SB, Satyanarayana S, Chadha SS, Kalemane S, Jaju J, Achanta S, Reddy K, Potharaju V, Shamrao SRM, Dewan P, Zachariah R, Tetali S, Anchala R, Kannuri NK, Harries AD, Singh SN
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How do patients who fail first-line TB treatment but who are not placed on an MDR-TB regimen fare in South India? | Journal Article / Research | MSF Science Portal
Abstract
SETTING
Seven districts in Andhra Pradesh, South India.

OBJECTIVES
To a) determine treatment outcomes of patients who fail first line anti-TB treatment and are not placed on an multi-drug resistant TB (MDR-TB) regimen, and b) relate the treatment outcomes to culture and drug susceptibility patterns (C&DST).

DESIGN
Retrospective cohort study using routine programme data and Mycobacterium TB Culture C&DST between July 2008 and December 2009.

RESULTS
There were 202 individuals given a re-treatment regimen and included in the study. Overall treatment outcomes were: 68 (34%) with treatment success, 84 (42%) failed, 36 (18%) died, 13 (6.5%) defaulted and 1 transferred out. Treatment success for category I and II failures was low at 37%. In those with positive cultures, 81 had pan-sensitive strains with 31 (38%) showing treatment success, while 61 had drug-resistance strains with 9 (15%) showing treatment success. In 58 patients with negative cultures, 28 (48%) showed treatment success.

CONCLUSION
Treatment outcomes of patients who fail a first-line anti-TB treatment and who are not placed on an MDR-TB regimen are unacceptably poor. The worst outcomes are seen among category II failures and those with negative cultures or drug-resistance. There are important programmatic implications which need to be addressed.

Countries

India

Subject Area

antibiotic resistancetuberculosisantimicrobial resistance

Languages

English
DOI
10.1371/journal.pone.0025698
Published Date
11 Oct 2011
PubMed ID
22022433
Journal
PLOS One
Volume | Issue | Pages
Volume 6, Issue 10, Pages E25698
Issue Date
2011-10-11
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