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Predictors of cure in rifampicin-resistant tuberculosis in prison settings with low loss to follow-up

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OBJECTIVE: To determine the factors predictive of cure among inmates with pulmonary rifampicin-resistant tuberculosis (RR-TB).

DESIGN: A total of 444 new and previously treated patients with pulmonary RR-TB who started treatment with second-line anti-tuberculosis drugs in the penitentiary system of Azerbaijan during the period 1 April 2007–28 February 2013 were retrospectively subjected to multivariate logistic regression analysis.

RESULTS: Of the 444 patients, 78.4% were cured. A higher number of effective bactericidal drugs in the regimen at months 7–12 and 13–18, normal chest X-ray and body mass index 18.5 kg/m2 at the treatment start significantly increased the chances of cure both in all cases (aOR 2.29, aOR 4.39, aOR 1.18, aOR 1.98 and aOR 1.97, respectively) and in retreatment cases (aOR 3.88, aOR 5.02, aOR 1.17, aOR 2.26 and aOR 1.90, respectively). There was no added benefit of using moxifloxacin (MFX) as compared to levofloxacin (LVX) in case of resistance to ofloxacin.

CONCLUSION: The use of a higher number of effective bactericidal drugs after month 6 of treatment for RR-TB was found to be the main factor associated with cure. No added benefit of using MFX instead of LVX was found. High cure rates can be achieved among vulnerable population groups such as prisoners if comprehensive TB control measures are in place to ensure low loss to follow-up.

Keywords: bactericidal anti-tuberculosis drugs; inmates; moxifloxacin; treatment outcome

Document Type: Research Article

Affiliations: 1: Main Medical Department, Ministry of Justice, Baku, Azerbaijan; Department of Pulmonary Medicine, University of Tartu, Tartu, Estonia 2: Main Medical Department, Ministry of Justice, Baku, Azerbaijan 3: Department of Communicable Disease Prevention and Control, Reykjavik Health Care Services, Reykjavik, Iceland 4: Department of Pulmonary Medicine, University of Tartu, Tartu, Estonia, Lung Clinic, Tartu University Hospital, Tartu, Estonia

Publication date: May 1, 2016

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