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Infection ; 45(6): 831-839, 2017 Dec.
Article in English | MEDLINE | ID: mdl-28779436

ABSTRACT

PURPOSE: The purpose of this study was to establish a baseline for measuring the impact of the programmatic management of drug-resistant TB program by following up on outcomes of all patients diagnosed with multidrug-resistant tuberculosis in Zambia between 2012 and 2014. METHODS: A cohort study of all the MDR-TB patients diagnosed at the national TB reference laboratory from across Zambia. MDR-TB was diagnosed by culture and DST, whereas outcome data were collected in 2015 by patient record checks and home visits. RESULTS: The total number of patients diagnosed was 258. Of those, 110 (42.6%) patients were traceable for this study. There were 67 survivor participants (60.9%); 43 (39.1%) were deceased. Out of the 110 patients who were traced, only 71 (64.5%) were started on second-line treatment. Twenty-nine (40.8%) patients were declared cured and 16.9% were still on treatment; 8.4% had failed treatment. The survival rate was 20.2 per 100 person-years of follow-up. Taking ARVs was associated with a decreased risk of dying (hazard ratio 0.12, p = 0.002). Sex, age, marital status and treatment category were not important predictors of survival in MDR-TB patients. CONCLUSIONS: More than half of the patients diagnosed with MDR-TB were lost to follow-up before second-line treatment was initiated.


Subject(s)
Antitubercular Agents/therapeutic use , Drug Resistance, Multiple, Bacterial , Mycobacterium tuberculosis/physiology , Tuberculosis, Multidrug-Resistant/drug therapy , Adolescent , Adult , Aged , Cohort Studies , Female , Humans , Male , Middle Aged , Mycobacterium tuberculosis/drug effects , Treatment Failure , Tuberculosis, Multidrug-Resistant/mortality , Young Adult , Zambia/epidemiology
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