9-12 months short treatment for patients with MDR-TB increases treatment success in Kyrgyzstan

  • Elena Zhdanova National Center of Phthisiology, Ministry of Health, Bishkek, Kyrgyz Republic
  • Olga Goncharova National Center of Phthisiology, Ministry of Health, Bishkek, Kyrgyz Republic
  • Hayk Davtyan Tuberculosis Research and Prevention Center, Yerevan, Armenia
  • Sevak Alaverdyan Tuberculosis Research and Prevention Center, Yerevan, Armenia
  • Aelita Sargsyan Tuberculosis Research and Prevention Center, Yerevan, Armenia
  • Anthony D Harries International Union against Tuberculosis and Lung Disease, Paris, France
  • Bolot Maykanaev National Center of Phthisiology, Ministry of Health, Bishkek, Kyrgyz Republic
Keywords: SORT IT, MDR/RR-TB, treatment outcomes, sputum culture conversion, short treatment, standard or individualized treatment

Abstract

Introduction: MDR/RR-TB is a growing problem in Kyrgyzstan. In 2005, the country introduced standard or individualized treatment for 20-24 months. Because of poor treatment outcomes, in 2017 a short treatment with strict eligibility criteria was introduced. The aim of this study was to compare characteristics and treatment outcomes of MDR/RR-TB patients receiving short (9-12 months) treatment in 2017 with those receiving standard or individualized (20-24 months) treatment in 2016/2017.

Methodology: A comparative cohort study using routine programmatic data. Characteristics, sputum culture conversion and treatment outcomes were compared between those on short treatment with those on standard/individualized treatment using the chi-square test, crude and adjusted risk ratios (RR and aRR).

Results: The study included 274, 82 and 132 patients on standard, individualized and short treatment, respectively. There were more females, fewer migrants/homeless and unemployed and more new TB patients on short treatment compared with the other two groups. A favorable outcome (cure and treatment completed) was significantly higher in short treatment patients (83%) compared with those on standard (50%) or individualized (59%) treatment (p < 0.001). There was higher 1-month sputum culture conversion with short treatment (35%) compared with the other two groups (19% and 24%, p < 0.05). Short treatment (aRR 1.6, 1.4-1.8), female gender (aRR 1.2, 1.1-1.4), not being homeless (aRR 12.9, 4.5-17.3) and having new TB (aRR 1.3, 1.0-1.5) were independently associated with a favorable outcome.

Conclusions: The treatment success was higher in selected MDR-TB patients given short treatment in Kyrgyzstan: this regimen should be scaled-up to all MDR-TB patients.

Published
2021-09-29
How to Cite
1.
Zhdanova E, Goncharova O, Davtyan H, Alaverdyan S, Sargsyan A, Harries AD, Maykanaev B (2021) 9-12 months short treatment for patients with MDR-TB increases treatment success in Kyrgyzstan. J Infect Dev Ctries 15:66S-74S. doi: 10.3855/jidc.13757
Section
EECA Regional SORT IT