Case Report: Therapeutic Threshold for Rifampicin-Resistant Tuberculosis: A Case Report from Maputo, Mozambique

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  • 1 Centro de Saude Primeiro de Maio, Maputo, Mozambique;
  • 2 Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;
  • 3 Research Foundation Flanders, Brussels, Belgium

We present a case of a patient in Mozambique, who initiated treatment for rifampicin-resistant tuberculosis (RR-TB) without proof of resistance. For this patient, we estimated the probability of RR-TB using likelihood ratios of clinical arguments. The probability of RR-TB in Mozambique, positive HIV status, and treatment failure after a first treatment and after retreatment were included as confirming arguments, and a rapid molecular test showing rifampicin susceptibility as excluding argument. The therapeutic threshold to start treatment for RR-TB is unknown, but probably lower than 47% and should be calculated to guide clinical decisions.

Author Notes

Address correspondence to Tinne Gils, Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, Antwerp 2000, Belgium. E-mail: tgils@itg.be

Authors’ addresses: Lorena D.M. Gonzaga, Centro de Saude Primeiro de Maio, Maputo, Mozambique, E-mail: lmougueret@gmail.com. Tinne Gils, Tom Decroo, Bart K. M. Jacobs, and Lutgarde Lynen, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium, E-mails: tgils@itg.be, tdecroo@itg.be, bkjacobs@itg.be, and llynen@itg.be.

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