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Treatment Outcomes for Patients with Multidrug-Resistant Tuberculosis in Post-Earthquake Port-au-Prince, Haiti

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  • Les Centres Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti; Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Masters of Science in Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Infectious Diseases, Center for Global Health, Weill Cornell Medical College, New York, New York

We report outcomes and 12-month survival for the first cohort of patients to undergo multidrug-resistant tuberculosis (MDR-TB) treatment after the earthquake in Haiti. From March 3, 2010 to March 28, 2013, 110 patients initiated treatment of laboratory-confirmed MDR-TB at the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Center in Port-au-Prince, Haiti. Twenty-seven patients (25%) were human immunodeficiency virus (HIV)-positive. As of October 31, 2013, 95 (86%) patients were either cured or alive on treatment, 4 (4%) patients defaulted, and 11 (10%) patients died. Culture conversion occurred by 30 days in 14 (13%) patients, 60 days in 49 (45%) patients, and 90 days in 81 (74%) patients. The probabilities of survival to 12 months were 96% (95% confidence interval [95% CI] = 89–99) and 85% (95% CI = 64–94) for HIV-negative and -positive patients, respectively. Despite adverse conditions, outcomes for patients with MDR-TB are highly encouraging. Major efforts are underway to scale up community directly observed therapy and expand care to other regions of Haiti.

Author Notes

* Address correspondence to Macarthur Charles, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333. E-mail: makchuk@gmail.com

Financial support: Support for the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Multidrug-Resistant Tuberculosis Program was obtained from the Centers for Disease Control and Prevention, the Global Fund for AIDS, Tuberculosis, and Malaria, the US President's Emergency Fund for AIDS Relief, and the Fogarty International Center. M.C. received support from the Mentored Patient-Oriented Research Career Development Award (K23 AI073190) and from the Robert Wood Johnson's Amos Medical Faculty Development Award (63526). S.P.K. received support from Research Project Grant R01AI104344. O.O. received support from the International Training and Education Center for Health (I-TECH) Grant Number HA000047.

Authors' addresses: Macarthur Charles, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: makchuk@gmail.com. Stalz Charles Vilbrun, Lauren M. Hashiguchi, Marie Marcelle Mabou, and Jean W. Pape, Les Centres Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti, E-mails: stalzsog@yahoo.com, mmabou@gheskio.org, lhashiguchi@gmail.com, and jwpape@gheskio.org. Serena P. Koenig, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, E-mail: skoenig@partners.org. Oksana Ocheretina, Center for Global Health, Division of Infectious Diseases, Weill Cornell Medical College, New York, NY, E-mail: ocheretina@yahoo.com.

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