Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Penang, Malaysia.
Department of Clinical Pharmacy, College of Pharmacy, Northern Border University, Rafha, Saudi Arabia.
Expert Rev Anti Infect Ther. 2019 Nov;17(11):927-937. doi: 10.1080/14787210.2019.1689818. Epub 2019 Nov 18.
: Multidrug-resistant tuberculosis (MDR-TB) has a socioeconomic impact and threatens global public health. We assessed treatment outcomes of MDR-TB and predictors of poor treatment outcomes in Sudan given current high prevalence rates.: Combined retrospective and prospective cohort study at Abu-Anga hospital (TB specialized hospital in Sudan). All patients with MDR-TB between 2013 and 2017 were targeted.: A total of 156 patients were recruited as having good records, 117 (75%) were male, and 152 (97.4%) had pulmonary TB. Patients were followed for a median of 18 months and a total of 2108 person-months. The overall success rate was 63.5% and the mortality rate was 14.1%. Rural residency (P < 0.05) and relapsing on previous treatments (P < 0.05) were determinants of time to poor MDR-TB treatment outcomes.: Overall, more attention needs to be given to special MDR-TB groups that are highly susceptible to poor outcomes, i.e. rural patients. As a result, it is highly recommended to maintain total coverage of medicines for all MDR-TB patients for the entire period of treatment in Sudan. It is also recommended to instigate more treatment centers in rural areas in Sudan together with programs to enhance adherence to treatments including patient counseling to improve future outcomes.
耐多药结核病(MDR-TB)具有社会经济影响,威胁着全球公共卫生。鉴于目前高患病率,我们评估了苏丹 MDR-TB 的治疗结果和不良治疗结果的预测因素。
阿布昂加医院(苏丹的结核病专科医院)进行的回顾性和前瞻性队列研究。2013 年至 2017 年间,所有 MDR-TB 患者均作为目标人群。
共招募了 156 名记录良好的患者,其中 117 名(75%)为男性,152 名(97.4%)患有肺结核。患者中位随访 18 个月,总随访 2108 人月。总成功率为 63.5%,死亡率为 14.1%。农村居民(P < 0.05)和既往治疗复发(P < 0.05)是 MDR-TB 治疗结果不良的时间的决定因素。
总体而言,需要更加关注特别容易出现不良结局的 MDR-TB 群体,即农村患者。因此,强烈建议在苏丹为所有 MDR-TB 患者在整个治疗期间全面覆盖药物。还建议在苏丹农村地区设立更多的治疗中心,并制定方案,加强对治疗的依从性,包括对患者进行咨询,以改善未来的结果。