Article Category:
Research Article

Predictors of Death in Rifampicin Resistant Tuberculosis Patients Treated with the Short Course in Conakry, Guinea

Salifou Talassone Bangoura Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea;
Département de Santé Publique, Gamal Abdel Nasser University, Conakry, Republic of Guinea;
Département des Sciences Pharmaceutiques et Biologiques, Gamal Abdel Nasser University, Conakry, Republic of Guinea;

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Boubacar Djelo Diallo Programme National de Lutte Antituberculeuse, Conakry, Republic of Guinea;
Service de Pneumo-Phtisiologie, Hôpital National Ignace Deen, Conakry, Republic of Guinea;

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Maladho Diaby Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea;

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Alioune Camara Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea;
Département de Santé Publique, Gamal Abdel Nasser University, Conakry, Republic of Guinea;

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Castro Gbêmêmali Hounmenou Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea;

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Aboubacar Sidiki Magassouba Programme National de Lutte Antituberculeuse, Conakry, Republic of Guinea;

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Kadio Jean-Jacques Olivier Kadio Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea;
Département de Santé Publique, Gamal Abdel Nasser University, Conakry, Republic of Guinea;
Département des Sciences Pharmaceutiques et Biologiques, Gamal Abdel Nasser University, Conakry, Republic of Guinea;

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Philippe Vanhems Santé Publique, Epidémiologie et Ecologie Evolutive des Maladies Infectieuses, Centre international de recherche en infectiologie, INSERM-U1111-UCBL Lyon 1-ENS Lyon, France;
Service d’Hygiène, Épidémiologie, Infectiovigilance et Prévention, Edouard Herriot Hospital, Hospices Civils de Lyon, France

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Abdoulaye Touré Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea;
Département de Santé Publique, Gamal Abdel Nasser University, Conakry, Republic of Guinea;
Département des Sciences Pharmaceutiques et Biologiques, Gamal Abdel Nasser University, Conakry, Republic of Guinea;

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Nagham Khanafer Santé Publique, Epidémiologie et Ecologie Evolutive des Maladies Infectieuses, Centre international de recherche en infectiologie, INSERM-U1111-UCBL Lyon 1-ENS Lyon, France;
Service d’Hygiène, Épidémiologie, Infectiovigilance et Prévention, Edouard Herriot Hospital, Hospices Civils de Lyon, France

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DOI:
https://doi.org/10.4269/ajtmh.23-0190
Volume/Issue:
Ahead of Print
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The emergence of rifampicin-resistant tuberculosis (RR-TB) is a major issue for TB control programs due to high risk of treatment failure and death. The objective of this study was to describe survival and to determine predictors of death in RR-TB patients treated with the short regimen (9–11 months) in the Conakry TB treatment centers. Sociodemographic, clinical, and survival data were collected prospectively between 2016 and 2021 on RR-TB patients in the Department of Pneumo-Phtisiology, the Carrière and the Tombolia TB centers. The Kaplan–Meier method was used to estimate the cumulative incidence of death of patients. The Cox regression model was used to identify the predictors independently associated with death. Of 869 patients, 164 (18.9%) patients died during treatment, 126 of them within 120 days of treatment initiation. The factors associated with death during treatment were as follows: patients treated in the Carrière TB center (adjusted hazard ratio [aHR] = 1.65; 95% CI: 1.06–2.59) and in the Department of Pneumo-Phtisiology (aHR = 3.26; 95% CI: 2.10–5.07), patients ≥ 55 years old (aHR = 4.80; 95% CI: 2.81–8.19), patients with no history of first-line TB treatment (aHR = 1.51; 95% CI: 1.05–2.16), and patients living with HIV (aHR = 2.81; 95% CI: 1.94–4.07). The results of this study can help the national TB control program to reconsider its therapeutic strategy to improve patient care in case of RR-TB. Large prospective clinical studies should be conducted to provide evidence of the impact of such factors like previous history of TB treatment and HIV infection on survival of RR-TB patients.

Author Notes

Disclosure: This study was conducted in accordance with the ethical principles of the Declaration of Helsinki and the Good Clinical Practice guidelines. Ethical approval was obtained from the national tuberculosis control program. Before the analyses, data were completely anonymized by removing all identifying variables and assignment with an identification number.

Authors’ addresses: Salifou Talassone Bangoura, Kadio Jean-Jacques Olivier Kadio, and Abdoulaye Touré, Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea, Département de Santé Publique, Gamal Abdel Nasser University, Conakry, Republic of Guinea, and Département des Sciences Pharmaceutiques et Biologiques, Gamal Abdel Nasser University, Conakry, Republic of Guinea, E-mails: talassoneb@gmail.com, drkadiojolivier@gmail.com, and abdoulaye.toure@cerfig.org. Boubacar Djelo Diallo, Programme National de Lutte Antituberculeuse, Conakry, Republic of Guinea, and Service de Pneumo-Phtisiologie, Hôpital National Ignace Deen, Conakry, Republic of Guinea, E-mail: diallodjelopneumo@gmail.com. Maladho Diaby and Castro Gbêmêmali Hounmenou, Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea, E-mails: mdiaby0390@gmail.com and castrohounmenou@gmail.com. Alioune Camara, Centre de Recherche et de Formation en Infectiologie de Guinée, Gamal Abdel Nasser University, Conakry, Republic of Guinea, and Département de Santé Publique, Gamal Abdel Nasser University, Conakry, Republic of Guinea, E-mail: aliounec@gmail.com. Aboubacar Sidiki Magassouba, Programme National de Lutte Antituberculeuse, Conakry, Republic of Guinea, E-mail: magasbakary01@yahoo.fr. Philippe Vanhems and Nagham Khanafer, Santé Publique, Epidémiologie et Ecologie Evolutive des Maladies Infectieuses, Centre international de recherche en infectiologie, INSERM-U1111-UCBL Lyon 1-ENS Lyon, Lyon, France, and Service d’Hygiène, Épidémiologie, Infectiovigilance et Prévention, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France, E-mails: philippe.vanhems@chu-lyon.fr and nagham.khanafer@chu-lyon.fr.

Address correspondence to Salifou Talassone Bangoura, Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Campus Universitaire Hadja Mafory Bangoura, Gamal Abdel Nasser University in Conakry, Donka, Conakry, PO Box 6629P, Republic of Guinea. E-mail: talassoneb@gmail.com
Copyright:
© American Society of Tropical Medicine and Hygiene 2023
Received:
26 Mar 2023
|
Accepted:
17 Sep 2023
|
Published Online:
13 Nov 2023
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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