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PLoS One ; 15(8): e0236264, 2020.
Article in English | MEDLINE | ID: mdl-32750060

ABSTRACT

BACKGROUND: Extensively drug-resistant tuberculosis (XDR TB) is a very serious form of tuberculosis that is burdened with a heavy mortality toll, especially before the advent of new TB drugs. The Democratic Republic of the Congo (DRC) is among the countries most affected by this new epidemic. METHODS: A retrospective analysis was performed of the records of all patients with pre- and extensively drug-resistant tuberculosis hospitalized from January 1, 2015 to December 31, 2017 and monitored for at least 6 months to one year after the end of their treatment in Kinshasa; an individualized therapeutic regimen with bedaquiline for 20 months was built for each patient. The adverse effects were systematically monitored. RESULTS: Of the 40 laboratory-confirmed patients, 32 (80%) patients started treatment, including 29 preXRB and 3 XDR TB patients. In the eligible group, 3 patients (9.4%) had HIV-TB coinfections. The therapeutic success rate was 53.2%, and the mortality rate was 46.8% (15/32); there were no relapses, failures or losses to follow-up. All coinfected HIV-TB patients died during treatment. The cumulative patient survival rate was 62.5% at 3 months, 53.1% at 6 months and 53.1% at 20 months. The most common adverse events were vomiting, Skin rash, anemia and peripheral neuropathy. CONCLUSION: The new anti-tuberculosis drugs are a real hope for the management of Drug Resistant tuberculosis patient and other new therapeutic combinations may improve favorable outcomes.


Subject(s)
Antitubercular Agents/administration & dosage , Diarylquinolines/administration & dosage , Extensively Drug-Resistant Tuberculosis/drug therapy , Adolescent , Adult , Aged , Anemia/chemically induced , Anemia/epidemiology , Antitubercular Agents/adverse effects , Cost of Illness , Democratic Republic of the Congo/epidemiology , Diarylquinolines/adverse effects , Drug Administration Schedule , Drug Therapy, Combination/adverse effects , Drug Therapy, Combination/methods , Exanthema/chemically induced , Exanthema/epidemiology , Extensively Drug-Resistant Tuberculosis/mortality , Female , Humans , Male , Middle Aged , Peripheral Nervous System Diseases/chemically induced , Peripheral Nervous System Diseases/epidemiology , Retrospective Studies , Survival Rate , Treatment Outcome , Vomiting/chemically induced , Vomiting/epidemiology , Young Adult
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