logo
Science Portal
Copyright © Médecins Sans Frontières
v2.1.5153.produseast1
About MSF Science Portal
About
Contact Us
Frequently Asked Questions (FAQs)
Privacy Policy
Terms of Use
Copyright © Médecins Sans Frontières
v2.1.5153.produseast1
Journal Article
|Research

Safety and effectiveness of an all-oral, bedaquiline-based, shorter treatment regimen for rifampicin-resistant tuberculosis in high HIV burden rural South Africa: a retrospective cohort analysis

Tack I, Dumicho A, Ohler L, Shigayeva A, Bulti AB, White K, Mbatha M, Furin J, Isaakidis P
Download

Similar Content
Loading...
Loading...
Loading...
Abstract
Background
At the end of 2018, South Africa updated its all-oral regimen, to include bedaquiline (BDQ) and two months of linezolid (LZD) for all patients initiating the shorter 9 to 12 months regimen for rifampicin-resistant tuberculosis (RR-TB). We assessed a group of patients in rural KwaZulu-Natal for safety and effectiveness of this treatment regimen under programmatic conditions.

Methods
We conducted a retrospective cohort analysis on RR-TB patients treated with a standardized all-oral short regimen between July 1, 2018 and April 30, 2019 in three facilities in King Cetshwayo District. An electronic register (EDR Web) and facility-based clinical charts were used to collect variables which were entered into an Epi-Info database.

Results
Our cohort included 117 patients; 68.4%(95%CI:59.3-76.3) were HIV positive. The median time to culture conversion was 56 days(95%CI:50-57). Treatment success was achieved in 75.2%(95%CI:66.5-82.3) of patients. Mortality within the cohort was 12.8%(95%CI:7.8-20.3). Anaemia was the most frequent severe adverse event. The median time to develop severe anaemia was 7.1 weeks(IQR 4.0-12.9) after treatment initiation. LZD was interrupted in 25.2%(95%CI:17.8-34.5) of participants.

Conclusions
An all-oral shorter regimen, including BDQ and LZD as core drugs for the treatment of RR-TB, shows good outcomes, in a high HIV burden rural setting. Adverse events (AEs) are common, especially for LZD, but could be managed in the program setting. Support is needed when introducing new regimens to upskill staff in the monitoring, management and reporting of AEs.

Countries

South Africa

Subject Area

tuberculosisHIV/AIDS

Languages

English
DOI
10.1093/cid/ciaa1894
Published Date
29 Dec 2020
PubMed ID
33372989
Journal
Clinical Infectious Diseases
Dimensions Badge
Safety and effectiveness of an all-oral, bedaquiline-based, shorter treatment regimen for rifampicin-resistant tuberculosis in high HIV burden rural South Africa: a retrospective cohort analysis | Journal Article / Research | MSF Science Portal