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Outcomes of a nine-month regimen for rifampicin-resistant tuberculosis up to 24 months after treatment completion in nine African countries

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dc.contributor.author Schwoebel, V. en_US
dc.contributor.author Trebucq, A. en_US
dc.contributor.author Kashongwe, Z. en_US
dc.contributor.author Bakayoko, A. S. en_US
dc.contributor.author Kuaban, C. en_US
dc.contributor.author Noeske, J. en_US
dc.contributor.author Harouna, S. H. en_US
dc.contributor.author Souleymane, M. B. en_US
dc.contributor.author Piubello, A. en_US
dc.contributor.author Ciza, F. en_US
dc.contributor.author Fikouma, V. en_US
dc.contributor.author Gasana, M. en_US
dc.contributor.author Ouedraogo, M. en_US
dc.contributor.author Gninafon, M. en_US
dc.contributor.author Van Deun, A. en_US
dc.contributor.author Tagliani, E. en_US
dc.contributor.author Cirillo, D. M. en_US
dc.contributor.author Koura, K. G. en_US
dc.contributor.author Rieder, H. L. en_US
dc.date.accessioned 2020-08-25T09:38:10Z
dc.date.available 2020-08-25T09:38:10Z
dc.date.issued 2020 en_US
dc.identifier.issn 2589-5370 en_US
dc.identifier.doi http://dx.doi.org/10.1016/j.eclinm.2020.100268 en_US
dc.identifier.other ITG-B15A; DBM; U-MYCOB; JIF; DOI; CPDF; PMC; Abstract; ITMPUB; DSPACE68 en_US
dc.identifier.uri http://hdl.handle.net/10390/10887
dc.description.abstract Background: Treatment outcomes of the shorter regimen for rifampicin-resistant tuberculosis are not completely established. We report on these outcomes two years after treatment completion among patients enrolled in an observational cohort study in nine African countries. Methods: 1,006 patients treated with the nine-month regimen were followed every six months with sputum cultures up to 24 months after treatment completion. The risk of any unfavourable outcome, of failure and relapse, and of death during and after treatment was analysed according to patient's characteristics and initial drug susceptibility by Cox proportional hazard models. Findings: Respectively 67.8% and 57.2% patients had >=1 culture result six months and 12 months after treatment completion. Fourteen relapses were diagnosed. The probability of relapse-free success was 79.3% (95% confidence interval [CI] 76.6-82.0%) overall, 80.9% (95% CI 78.0-84.0%) among HIV-negative and 72.5% (95% CI 66.5-78.9%) among HIV-infected patients. Initial fluoroquinolone (adjusted hazard ratio [aHR] 6.7 [95% CI 3.4-13.1]) and isoniazid resistance (aHR 9.4 [95% CI 1.3-68.0]) were significantly associated with increased risk of failure/relapse and of any unfavourable outcome. Interpretation: The close to 80% relapse-free success indicates the good outcome of the regimen in low-and middle-income settings. Results confirm the lesser effectiveness of the regimen in patients with initial resistance to fluoroquinolones and support the use of high-dose isoniazid, but do not support exclusion of patients for resistance to drugs other than fluoroquinolones. Funding: Expertise-France and Agence Francaise de Developpement. en_US
dc.language English en_US
dc.relation.uri http://www.ncbi.nlm.nih.gov/pubmed/32300732 en_US
dc.subject Tuberculosis-rifampicin-resistant en_US
dc.subject Bacterial diseases en_US
dc.subject Treatment en_US
dc.subject Outcomes en_US
dc.subject Africa-General en_US
dc.title Outcomes of a nine-month regimen for rifampicin-resistant tuberculosis up to 24 months after treatment completion in nine African countries en_US
dc.type Article-E en_US
dc.citation.jtitle EClinicalMedicine en_US
dc.citation.volume 20 en_US
dc.citation.pages 100268 en_US
dc.citation.abbreviation EClinicalMedicine en_US


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