Successful management of multidrug-resistant tuberculosis under programme conditions in the Dominican Republic

M. Rodriguez, I. Monedero, J. A. Caminero, M. Encarnación, Y. Dominguez, I. Acosta, E. Muñoz, E. Camilo, S. Martinez-Selmo, S. De Los Santos, M. Del Granado, M. Casals, J. Cayla, B. Marcelino

Research output: Contribution to journalArticle

Abstract

SETTING: The Dominican Republic is a high-incidence area for multidrug-resistant tuberculosis (MDR-TB; 6.6% of initial cases). Standardised treatment regimens for MDR-TB may be a potential solution. OBJECTIVE: To present the effectiveness of standard regimens under routine national conditions. DESIGN: We reviewed all MDR-TB patients treated under routine conditions from 29 August 2006 to 30 June 2010, showing interim and final outcomes. Patients were treated with regimens that were standardised or individualised based on previously received secondline anti- tuberculosis drugs. RESULTS: Population description and culture conversion data are reported for the 289 MDR-TB patients. The median patient age was 31 years. Most had failed first-line treatment (72.6%). Culture negativity was obtained within 4 months (median 2 months) in 78.6%. Among the 150 patients treated between 2006 and 2008, 74% had favourable results on standardised and 66% on individualised regimens (P = 0.211). The efficacy of the standardised and individualised regimens was respectively 92.8% and 81% (P = 0.056). The relapse rate was approximately 1%. A median of five drug side effects occurred per patient. More than 2 months to culture conversion and bilateral cavitation on chest X-ray were found to be unfavourable outcome risk factors. CONCLUSIONS: Standardised MDR-TB regimens may be effective at the national level, even in resource-poor settings.

Original languageEnglish (US)
Pages (from-to)520-525
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume17
Issue number4
DOIs
StatePublished - Apr 1 2013

Keywords

  • Dominican Republic
  • MDR-TB
  • Multidrug-resistant tuberculosis
  • Standardised treatment
  • TB
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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    Rodriguez, M., Monedero, I., Caminero, J. A., Encarnación, M., Dominguez, Y., Acosta, I., Muñoz, E., Camilo, E., Martinez-Selmo, S., De Los Santos, S., Del Granado, M., Casals, M., Cayla, J., & Marcelino, B. (2013). Successful management of multidrug-resistant tuberculosis under programme conditions in the Dominican Republic. International Journal of Tuberculosis and Lung Disease, 17(4), 520-525. https://doi.org/10.5588/ijtld.12.0481