RESUMO
ABSTRACT Objective: Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening infectious disease. Treatment requires multiple antimicrobial agents used for extended periods of time. The present study sought to evaluate the treatment success rate of bedaquiline-based regimens in MDR-TB patients. Methods: This was a systematic review and meta-analysis of studies published up to March 15, 2021. The pooled treatment success rates and 95% CIs were assessed with the fixed-effect model or the random-effects model. Values of p < 0.05 were considered significant for publication bias. Results: A total of 2,679 articles were retrieved by database searching. Of those, 29 met the inclusion criteria. Of those, 25 were observational studies (including a total of 3,536 patients) and 4 were experimental studies (including a total of 440 patients). The pooled treatment success rate was 74.7% (95% CI, 69.8-79.0) in the observational studies and 86.1% (95% CI, 76.8-92.1; p = 0.00; I2 = 75%) in the experimental studies. There was no evidence of publication bias (p > 0.05). Conclusions: In patients with MDR-TB receiving bedaquiline, culture conversion and treatment success rates are high even in cases of extensive resistance.
RESUMO Objetivo: A tuberculose multirresistente (MDR-TB, do inglês multidrug-resistant tuberculosis) é uma doença infecciosa potencialmente fatal. O tratamento exige múltiplos agentes antimicrobianos usados durante longos períodos. O presente estudo buscou avaliar a taxa de sucesso de esquemas terapêuticos com bedaquilina em pacientes com MDR-TB. Métodos: Trata-se de uma revisão sistemática e meta-análise de estudos publicados até 15 de março de 2021. As taxas combinadas de sucesso do tratamento e os IC95% foram avaliados por meio do modelo de efeito fixo ou do modelo de efeitos aleatórios. Valores de p < 0,05 foram considerados significativos para viés de publicação. Resultados: Por meio de buscas eletrônicas em bancos de dados, foram recuperados 2.679 artigos. Destes, 29 preencheram os critérios de inclusão. Destes, 25 eram estudos observacionais (com um total de 3.536 pacientes) e 4 eram estudos experimentais (com um total de 440 pacientes). A taxa combinada de sucesso do tratamento foi de 74,7% (IC95%: 69,8-79,0) nos estudos observacionais e de 86,1% (IC95%: 76,8-92,1; p = 0,00; I2 = 75%) nos estudos experimentais. Não foram encontradas evidências de viés de publicação (p > 0,05). Conclusões: Em pacientes com MDR-TB tratados com bedaquilina, as taxas de conversão da cultura e sucesso do tratamento são altas mesmo em casos de resistência extensa.
RESUMO
Hydatid cyst disease is a zoonotic infectious disease occured by larvae of Echinococcus worms. Echinococcusis has a world-wide distribution and is an endemic disease in our country and causes many mortality and morbidity every year. The main aim of this research is to study different epidemiologic aspects of Hydatid cyst disease in 2011 -2012 at three general hospital of Tehran. In this descriptive study, we evaluated all hospital records of 137 patients whose final diagnoses were hydatid cyst disease. Some of patient's information such as age, sex, occupation, living place, disease recurrence, type of treatment and its final result, cyst rupture, patient's chief complaint, and radiological findings collected in a registry form and finally, these data were analyzed by SPSS16 statistical software. Based on the 137 patient's hospital records, we found that 50.4 percent were male and 49.6 percent were female, most of them were between 26 and 35 years old, 39.4 percent of them were housewives, 79 percent of them were living in urban area and 21 percent were living in rural area, liver was the involved organ in 76.8 percent, rate of disease recurrence was 17.4 percent, 5.1 percent of cysts were ruptured, the rate of larvemia was 16 percent, from patients who had serologic test, the result of 53.3 percent was positive, all cases evaluated by sonography and CT scan showed the positive results, but only 30 percent of chest radiographies were positive, the 38.4 percent of the patient's chief complaint were abdominal pain, the treatment plan in 82.3 percent of cases was open surgery, in 11.1 percent was drug administration, and in 6.1 percent was cyst derenage under sonography guide, 90.5 percent of outcome were cure and 1.4 percent of cases ended with death. The people's knowledge about Hydatidos plays an important role in controlling and preventing of it. Also, in order to have a real estimate of disease prevalence and an effective program for elimination of it, we need to correct our disease surveillance system and improve our registry system