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High Mortality Associated with Retreatment of Tuberculosis in a Clinic in Kampala, Uganda: A Retrospective Study
The World Health Organization recommends for tuberculosis retreatment a regimen of isoniazid (H), rifampicin (R), ethambutol (E), pyrazinamide (Z), and streptomycin (S) for 2 months, followed by H, R, E, and Z for 1 month and H, R, and E for 5 months. Using data from the National Tuberculosis and Leprosy Program registry, this study determined the long-term outcome under programmatic conditions of patients who were prescribed the retreatment regimen in Kampala, Uganda, between 1997 and 2003. Patients were traced to determine their vital status; 62% (234/377) patients were found dead. Having ≤ 2 treatment courses and not completing retreatment were associated with mortality in adjusted analyses.
Author Notes
Financial support: The study was supported by a University of Medicine and Dentistry of New Jersey (now Rutgers University) Foundation award with matching funds from the Division of Infectious Diseases at New Jersey Medical School–Rutgers University.
Authors' addresses: Carlos Acuña-Villaorduña and Edward C. Jones-López, Section of Infectious Diseases, Boston Medical Center, Boston, MA, E-mails: carlosvillaorduna@hotmail.com and edward.jones@bmc.org. Irene Ayakaka, Makerere University–Boston Medical Center Research Collaboration, Kampala, Uganda, E-mail: ayakaka@gmail.com. Scott Dryden-Peterson, Medicine and Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, E-mail: slpeterson@partners.org. Susan Nakubulwa, Uganda Research Unit on AIDS, Medical Research Council–Uganda Virus Research Institute, Entebbe, Uganda, E-mail: susan.nakubulwa@mrcuganda.org. William Worodria, Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda, E-mail: wworo@hotmail.com. Nancy Reilly, Department of Medicine, New Jersey Medical School–Rutgers University, Newark, NJ, E-mail: reillyna@njms.rudgers.edu. Jennifer Hosford and Kevin P. Fennelly, Division of Infectious Diseases and Global Medicine, University of Florida, Gainsville, FL, E-mails: jennifer.hosford@medicine.ufl.edu and kevin.fennelly@medicine.ufl.edu. Alphonse Okwera, Tuberculosis Clinic, Mulago Hospital, Kampala, Uganda, E-mail: a_okwera@mcuwru.edu.