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Treatment Outcomes and Adverse Events from a Standardized Multidrug-Resistant Tuberculosis Regimen in a Rural Setting in Angola

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  • 1 Tropical Medicine and International Health Unit Vall d’Hebron-Drassanes PROSICS Barcelona, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain;
  • | 2 Hospital Nossa Senhora da Paz, Cubal, Angola;
  • | 3 Microbiology Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain;
  • | 4 Support Research Unit, Territorial Health Management of Central Catalonia, Catalonia, Spain
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Treatment for multidrug-resistant tuberculosis (MDR TB) is associated with adverse events (AE). Patients treated with an MDR TB regimen in Hospital Nossa Senhora da Paz, Cubal, Angola, were prospectively enrolled from May 2013 to July 2015. Baseline characteristics, AE, and clinical and microbiological outcomes were recorded. A total of 216 patients were treated with an MDR TB regimen and 179 (82.9%) patients developed at least one AE. The most common AE were elevation of liver enzymes (46.8% of patients), elevated creatinine (44.4% of patients), and ototoxicity (40.7% of patients). Previous TB treatment was associated with the occurrence of AE (OR 4.89, 95% CI: 2.09–11.46, P < 0.001) and months on treatment was associated to severe AE (OR 1.11 95% CI: 1.04–1.18, P = 0.001). Successful treatment was achieved in 117 (54.2%) patients. Incidence of AE was associated with an unsuccessful outcome (OR 1.23, 95% CI: 1.09–1.40, P = 0.001). Patients treated with MDR TB treatment frequently experience AE, and these are related with previous TB treatment and duration of treatment. Given the high percentage of patients experiencing AE and the low treatment success rates, more effective and less toxic drugs to treat MDR TB are urgently needed.

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Author Notes

Address correspondence to María Luisa Aznar, Infectious Disease Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119–129, Barcelona 08035, Spain. E-mail: maznarru@gmail.com

Financial support: We are grateful for the financial support received from the Probitas Foundation, which not only made it possible to purchase the equipment and reagents to launch the Xpert study, but to also strengthen the capacity of the laboratory and local staff.

Authors’ addresses: María Luisa Aznar, Cristina Bocanegra, and Israel Molina, PROSICS Barcelona and Medicine Department, Tropical Medicine and International Health Unit, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain, E-mails: maznarru@gmail.com, cristinabocanegra@gmail.com, and israelmolina@ymail.com. María Milagros Moreno, Eva Gil Olivas, Arlete Nindia Eugénio, Adriano Zacarias, Domingos Katimba, Estevao Gabriel, and Maria Teresa López García, Hospital Nossa Senhora da Paz, Cubal, Angola, E-mails: milamor14@yahoo.es, evagilolivas1982@gmail.com, arletenindacubal@yahoo.com, adrianozacarias1967@yahoo.com, domingoskatimba1977@yahoo.com, estevaogabriel1968@yahoo.com, and materloga2@yahoo.es. Ariadna Rando Segura, Mateu Espasa, Elena Sulleiro, Tomas Pumarola, and María Teresa Tórtola, Microbiology Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain, E-mails: ariadnarando@gmail.com, mespasa@vhebron.net, esulleir@vhebron.net, tpumarola@vhebron.net, and ttortola@vhebron.net. Jacobo Mendioroz, Support Research Unit, Territorial Health Management of Central Catalonia, Catalonia, Spain, E-mail: jmendioroz.cc.ics@gencat.cat.

These authors were contributed equally to this work.

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