1. Outcomes and adverse events of pre- and extensively drug-resistant tuberculosis patients in Kinshasa, Democratique Republic of the Congo: A retrospective cohort study.
- Author
-
Kashongwe IM, Mawete F, Mbulula L, Nsuela DJ, Losenga L, Anshambi N, Aloni M, Kaswa M, Kayembe JMN, Umba P, Lepira FB, and Kashongwe ZM
- Subjects
- Adolescent, Adult, Aged, Anemia chemically induced, Anemia epidemiology, Antitubercular Agents adverse effects, Cost of Illness, Democratic Republic of the Congo epidemiology, Diarylquinolines adverse effects, Drug Administration Schedule, Drug Therapy, Combination adverse effects, Drug Therapy, Combination methods, Exanthema chemically induced, Exanthema epidemiology, Extensively Drug-Resistant Tuberculosis mortality, Female, Humans, Male, Middle Aged, Peripheral Nervous System Diseases chemically induced, Peripheral Nervous System Diseases epidemiology, Retrospective Studies, Survival Rate, Treatment Outcome, Vomiting chemically induced, Vomiting epidemiology, Young Adult, Antitubercular Agents administration & dosage, Diarylquinolines administration & dosage, Extensively Drug-Resistant Tuberculosis drug therapy
- Abstract
Background: Extensively drug-resistant tuberculosis (XDR TB) is a very serious form of tuberculosis that is burdened with a heavy mortality toll, especially before the advent of new TB drugs. The Democratic Republic of the Congo (DRC) is among the countries most affected by this new epidemic., Methods: A retrospective analysis was performed of the records of all patients with pre- and extensively drug-resistant tuberculosis hospitalized from January 1, 2015 to December 31, 2017 and monitored for at least 6 months to one year after the end of their treatment in Kinshasa; an individualized therapeutic regimen with bedaquiline for 20 months was built for each patient. The adverse effects were systematically monitored., Results: Of the 40 laboratory-confirmed patients, 32 (80%) patients started treatment, including 29 preXRB and 3 XDR TB patients. In the eligible group, 3 patients (9.4%) had HIV-TB coinfections. The therapeutic success rate was 53.2%, and the mortality rate was 46.8% (15/32); there were no relapses, failures or losses to follow-up. All coinfected HIV-TB patients died during treatment. The cumulative patient survival rate was 62.5% at 3 months, 53.1% at 6 months and 53.1% at 20 months. The most common adverse events were vomiting, Skin rash, anemia and peripheral neuropathy., Conclusion: The new anti-tuberculosis drugs are a real hope for the management of Drug Resistant tuberculosis patient and other new therapeutic combinations may improve favorable outcomes., Competing Interests: No authors have competing interests.
- Published
- 2020
- Full Text
- View/download PDF