Outcomes and adverse events of pre- and extensively drug-resistant tuberculosis patients in Kinshasa, Democratique Republic of the Congo: A retrospective cohort study

Extensively drug-resistant tuberculosis (XDR TB) is a very serious form of tuberculosis that is burdened with a heavy mortality toll, especially before the advent of new TB drugs. The Democratic Republic of the Congo (DRC) is among the countries most affected by this new epidemic. A retrospective an...

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Bibliographic Details
Published in:PloS one 2020-08, Vol.15 (8), p.e0236264-e0236264
Main Authors: Kashongwe, Innocent Murhula, Mawete, Fina, Mbulula, Leopoldine, Nsuela, Don Jean, Losenga, Luc, Anshambi, Nicole, Aloni, Murielle, Kaswa, Michel, Kayembe, Jean Marie Ntumba, Umba, Pierre, Lepira, Francois Bompeka, Kashongwe, Zacharie Munogolo
Format: Article
Language:English
Subjects:
Anemia
Bedaquiline
Classification
Cohort analysis
Complications and side effects
Drug dosages
Drug resistance
Drug therapy
Drugs
Epidemics
Excellence
HIV
Hospitalization
Hospitals
Human immunodeficiency virus
Internal medicine
Laboratories
Medical diagnosis
Medical research
Medicine
Medicine and Health Sciences
Microbial drug resistance
Mortality
Multidrug resistant organisms
Patient outcomes
Patients
Peacekeeping forces
Performance evaluation
Peripheral neuropathy
Research and Analysis Methods
Supervision
Survival
Tuberculosis
Vomiting
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Summary:Extensively drug-resistant tuberculosis (XDR TB) is a very serious form of tuberculosis that is burdened with a heavy mortality toll, especially before the advent of new TB drugs. The Democratic Republic of the Congo (DRC) is among the countries most affected by this new epidemic. A retrospective analysis was performed of the records of all patients with pre- and extensively drug-resistant tuberculosis hospitalized from January 1, 2015 to December 31, 2017 and monitored for at least 6 months to one year after the end of their treatment in Kinshasa; an individualized therapeutic regimen with bedaquiline for 20 months was built for each patient. The adverse effects were systematically monitored. Of the 40 laboratory-confirmed patients, 32 (80%) patients started treatment, including 29 preXRB and 3 XDR TB patients. In the eligible group, 3 patients (9.4%) had HIV-TB coinfections. The therapeutic success rate was 53.2%, and the mortality rate was 46.8% (15/32); there were no relapses, failures or losses to follow-up. All coinfected HIV-TB patients died during treatment. The cumulative patient survival rate was 62.5% at 3 months, 53.1% at 6 months and 53.1% at 20 months. The most common adverse events were vomiting, Skin rash, anemia and peripheral neuropathy. The new anti-tuberculosis drugs are a real hope for the management of Drug Resistant tuberculosis patient and other new therapeutic combinations may improve favorable outcomes.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0236264