High rate of successful treatment outcomes among childhood rifampicin/multidrug-resistant tuberculosis in Pakistan: a multicentre retrospective observational analysis

Abstract Background There was a complete lack of information about the treatment outcomes of rifampicin/multidrug resistant (RR/MDR) childhood TB patients (age ≤ 14 years) from Pakistan, an MDR-TB 5th high burden country. Therefore, this study evaluated the socio-demographic characteristics, drug re...

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Autores principales:	Farah Naz, Nafees Ahmad, Abdul Wahid, Izaz Ahmad, Asad Khan, Muhammad Abubakar, Shabir Ahmed Khan, Amjad Khan, Abdullah Latif, Abdul Ghafoor
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Childhood Ethambutol Females Rifampicin resistant-TB MDR-TB Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/88dfaa58a9754ee6b500d4b58229f956
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spelling	oai:doaj.org-article:88dfaa58a9754ee6b500d4b58229f9562021-12-05T12:26:10ZHigh rate of successful treatment outcomes among childhood rifampicin/multidrug-resistant tuberculosis in Pakistan: a multicentre retrospective observational analysis10.1186/s12879-021-06935-61471-2334https://doaj.org/article/88dfaa58a9754ee6b500d4b58229f9562021-12-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06935-6https://doaj.org/toc/1471-2334Abstract Background There was a complete lack of information about the treatment outcomes of rifampicin/multidrug resistant (RR/MDR) childhood TB patients (age ≤ 14 years) from Pakistan, an MDR-TB 5th high burden country. Therefore, this study evaluated the socio-demographic characteristics, drug resistance pattern, treatment outcomes and factors associated with unsuccessful outcomes among childhood RR/MDR-TB patients in Pakistan. Methods This was a multicentre retrospective record review of all microbiologically confirmed childhood RR/MDR-TB patients (age ≤ 14 years) enrolled for treatment at seven units of programmatic management of drug-resistant TB (PMDT) in Pakistan. The baseline and follow-up information of enrolled participants from treatment initiation until the end of treatment were retrieved from electronic nominal recording and reporting system. World Health Organization (WHO) defined criterion was used for deciding treatment outcomes. The outcomes of “cured” and “treatment completed” were collectively grouped as successful, whereas “death”, “treatment failure” and “lost to follow-up” were grouped together as unsuccessful outcomes. Multivariable binary logistic regression analysis was used to find factors associated with unsuccessful outcomes. A p-value < 0.05 reflected statistically significant findings. Results A total of 213 children RR/MDR-TB (84 RR and 129 MDR-TB) were included in the study. Majority of them were females (74%), belonged to the age group 10–14 years (82.2%) and suffered from pulmonary TB (85.9%). A notable proportion (37.1%) of patients had no history of previous TB treatment. Patients were resistant to a median of two drugs (interquartile range: 1–4) and 23% were resistant to any second line anti-TB drug. A total of 174 (81.7%) patients achieved successful treatment outcomes with 144 (67.6%) patients being cured and 30 (14.1%) declared treatment completed. Among the 39 (18.3%) patients with unsuccessful outcomes, 35 (16.4%) died and 4 (1.9%) experienced treatment failure. In multivariable analysis, the use of ethambutol had statistically significant negative association with unsuccessful outcomes (odds ratio = 0.36, p-value = 0.02). Conclusions In this study, the WHO target of successful treatment outcomes (≥ 75%) among childhood RR/MDR-TB patients was achieved. The notable proportion of patients with no history of previous TB treatment (37.1%) and the disproportionately high number of female patients (74%) respectively stress for infection control measures and provision of early and high quality care for female drug susceptible TB patients.Farah NazNafees AhmadAbdul WahidIzaz AhmadAsad KhanMuhammad AbubakarShabir Ahmed KhanAmjad KhanAbdullah LatifAbdul GhafoorBMCarticleChildhoodEthambutolFemalesRifampicin resistant-TBMDR-TBInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Childhood Ethambutol Females Rifampicin resistant-TB MDR-TB Infectious and parasitic diseases RC109-216
spellingShingle	Childhood Ethambutol Females Rifampicin resistant-TB MDR-TB Infectious and parasitic diseases RC109-216 Farah Naz Nafees Ahmad Abdul Wahid Izaz Ahmad Asad Khan Muhammad Abubakar Shabir Ahmed Khan Amjad Khan Abdullah Latif Abdul Ghafoor High rate of successful treatment outcomes among childhood rifampicin/multidrug-resistant tuberculosis in Pakistan: a multicentre retrospective observational analysis
description	Abstract Background There was a complete lack of information about the treatment outcomes of rifampicin/multidrug resistant (RR/MDR) childhood TB patients (age ≤ 14 years) from Pakistan, an MDR-TB 5th high burden country. Therefore, this study evaluated the socio-demographic characteristics, drug resistance pattern, treatment outcomes and factors associated with unsuccessful outcomes among childhood RR/MDR-TB patients in Pakistan. Methods This was a multicentre retrospective record review of all microbiologically confirmed childhood RR/MDR-TB patients (age ≤ 14 years) enrolled for treatment at seven units of programmatic management of drug-resistant TB (PMDT) in Pakistan. The baseline and follow-up information of enrolled participants from treatment initiation until the end of treatment were retrieved from electronic nominal recording and reporting system. World Health Organization (WHO) defined criterion was used for deciding treatment outcomes. The outcomes of “cured” and “treatment completed” were collectively grouped as successful, whereas “death”, “treatment failure” and “lost to follow-up” were grouped together as unsuccessful outcomes. Multivariable binary logistic regression analysis was used to find factors associated with unsuccessful outcomes. A p-value < 0.05 reflected statistically significant findings. Results A total of 213 children RR/MDR-TB (84 RR and 129 MDR-TB) were included in the study. Majority of them were females (74%), belonged to the age group 10–14 years (82.2%) and suffered from pulmonary TB (85.9%). A notable proportion (37.1%) of patients had no history of previous TB treatment. Patients were resistant to a median of two drugs (interquartile range: 1–4) and 23% were resistant to any second line anti-TB drug. A total of 174 (81.7%) patients achieved successful treatment outcomes with 144 (67.6%) patients being cured and 30 (14.1%) declared treatment completed. Among the 39 (18.3%) patients with unsuccessful outcomes, 35 (16.4%) died and 4 (1.9%) experienced treatment failure. In multivariable analysis, the use of ethambutol had statistically significant negative association with unsuccessful outcomes (odds ratio = 0.36, p-value = 0.02). Conclusions In this study, the WHO target of successful treatment outcomes (≥ 75%) among childhood RR/MDR-TB patients was achieved. The notable proportion of patients with no history of previous TB treatment (37.1%) and the disproportionately high number of female patients (74%) respectively stress for infection control measures and provision of early and high quality care for female drug susceptible TB patients.
format	article
author	Farah Naz Nafees Ahmad Abdul Wahid Izaz Ahmad Asad Khan Muhammad Abubakar Shabir Ahmed Khan Amjad Khan Abdullah Latif Abdul Ghafoor
author_facet	Farah Naz Nafees Ahmad Abdul Wahid Izaz Ahmad Asad Khan Muhammad Abubakar Shabir Ahmed Khan Amjad Khan Abdullah Latif Abdul Ghafoor
author_sort	Farah Naz
title	High rate of successful treatment outcomes among childhood rifampicin/multidrug-resistant tuberculosis in Pakistan: a multicentre retrospective observational analysis
title_short	High rate of successful treatment outcomes among childhood rifampicin/multidrug-resistant tuberculosis in Pakistan: a multicentre retrospective observational analysis
title_full	High rate of successful treatment outcomes among childhood rifampicin/multidrug-resistant tuberculosis in Pakistan: a multicentre retrospective observational analysis
title_fullStr	High rate of successful treatment outcomes among childhood rifampicin/multidrug-resistant tuberculosis in Pakistan: a multicentre retrospective observational analysis
title_full_unstemmed	High rate of successful treatment outcomes among childhood rifampicin/multidrug-resistant tuberculosis in Pakistan: a multicentre retrospective observational analysis
title_sort	high rate of successful treatment outcomes among childhood rifampicin/multidrug-resistant tuberculosis in pakistan: a multicentre retrospective observational analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/88dfaa58a9754ee6b500d4b58229f956
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High rate of successful treatment outcomes among childhood rifampicin/multidrug-resistant tuberculosis in Pakistan: a multicentre retrospective observational analysis

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