Outcomes and follow-up of patients treated for multidrug-resistant tuberculosis in Orel, Russia, 2002–2005
Abstract:SETTING: Multidrug-resistant tuberculosis (MDR-TB) treatment facility, Orel Oblast, Russian Federation.
OBJECTIVES: To determine factors associated with poor outcome and to document status of patients after recording of TB outcomes.
DESIGN: Retrospective review of prospective single cohort.
RESULTS: Among 192 patients, factors significantly associated with poor outcome in multivariate analysis include three or more treatment interruptions during the intensive phase of therapy and alcohol or drug addiction (adjusted OR [aOR] 2.1, 95%CI 1.0–4.3 and aOR 1.9, 95%CI 1.0–3.7). Previous treatment was associated with poor outcome, but only among smear-positive patients (aOR 3.1, 95%CI 1.3–7.3). Ten patients (5%) developed extensively drug-resistant TB (XDR-TB) during treatment; of 115 patients with at least 6 months of follow-up data after outcomes were recorded, 13 (11%) developed XDR-TB.
CONCLUSION: Interventions focused on supporting patient adherence during the intensive phase of treatment; the management of drug and alcohol addiction should be developed and studied. A substantial proportion of patients developed XDR-TB during and after treatment. Longer term follow-up data of patients treated for MDR-TB are needed to better inform programmatic policy.
Document Type: Research Article
Affiliations: 1: Division of Tuberculosis Elimination, and Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2: Orel Oblast Central Tuberculosis Dispensary, Orel, Russia 3: Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA 4: Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Publication date: August 1, 2012
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