Outcome of treatment of MDR-TB or drug-resistant patients treated with bedaquiline and delamanid: Results from a large global cohort.

The World Health Organization (WHO) recommends countries introduce new anti-TB drugs in the treatment of multidrug-resistant tuberculosis. The aim of the study is to prospectively evaluate the effectiveness of bedaquiline (and/or delamanid)- containing regimens in a large cohort of consecutive TB patients treated globally. This observational, prospective study is based on data collected and provided by Global Tuberculosis Network (GTN) centres and analysed twice a year. All consecutive patients (including children/adolescents) treated with bedaquiline and/or delamanid were enrolled, and managed according to WHO and national guidelines. Overall, 52 centres from 29 countries/regions in all continents reported 883 patients as of January 31st 2021, 24/29 countries/regions providing data on 100% of their consecutive patients (10-80% in the remaining 5 countries). The drug-resistance pattern of the patients was severe (>30% with extensively drug-resistant -TB; median number of resistant drugs 5 (3-7) in the overall cohort and 6 (4-8) among patients with a final outcome). For the patients with a final outcome (477/883, 54.0%) the median (IQR) number of months of anti-TB treatment was 18 (13-23) (in days 553 (385-678)). The proportion of patients achieving sputum smear and culture conversion ranged from 93.4% and 92.8% respectively (whole cohort) to 89.3% and 88.8% respectively (patients with a final outcome), a median (IQR) time to sputum smear and culture conversion of 58 (30-90) days for the whole cohort and 60 (30-100) for patients with a final outcome and, respectively, of 55 (30-90) and 60 (30-90) days for culture conversion. Of 383 patients treated with bedaquiline but not delamanid, 284 (74.2%) achieved treatment success, while 25 (6.5%) died, 11 (2.9%) failed and 63 (16.5%) were lost to follow-up.

Awareness of the risks of HIV infection by Zimbabwean urban and rural high school attendees.

OBJECTIVES: The purpose of this report was to investigate the awareness by high school attendees of risky behaviour likely to lead to sexually transmitted infections (STIs) including HIV/AIDS and to assess their preparedness to prevent or obviate the consequences. DESIGN: Cross sectional study. SETTINGS: A small town located 100 km south of the Zimbabwean capital, Harare and in communal and commercial farming areas within a 50 km radius of the town. METHODS: With the permission of school authorities, a group of second year medical students from the University of Zimbabwe on rural attachment administered an anonymous questionnaire to teenagers attending four high schools in the study area. Specific questions to determine whether the teenagers were sexually active and if they used any protection during sex were incorporated into a general and environmental health questionnaire. RESULTS: A total of 241 teenagers, 153 boys and 89 girls from all four schools completed the questionnaire. The percentages of sexually active boys (48%) and girls (49%) were similar. The majority had heterosexual preferences, 4.6% boys were homosexual. Half (50%) of the 16 year old pupils were sexually active. There were more urban than rural school attendees who reported personal knowledge of someone with HIV or AIDS. Condom use was low. CONCLUSION: We found that half of the 16 to 19 year old students were sexually active. Rural school attendees were more likely to be sexually active and less likely to practice safe sex. We conclude that the risk of sexually transmitted diseases (including HIV) amongst these teenagers is significant and recommend that, there is a need to design a group targeted awareness programme in order to obviate sexually transmitted diseases including HIV.