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Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre study

Ghimire, S., Karki, S., Maharjan, B., Kosterink, J. G. W., Touw, D. J., van der Werf, T. S., Shrestha, B. & Alffenaar, J-W., Aug-2020, In : BMJ open respiratory research. 7, 1, 8 p., e000606.

Research output: Contribution to journalArticleAcademicpeer-review

OBJECTIVES: The objectives of this study were to evaluate treatment in patients on current programmatic multidrug-resistant tuberculosis (MDR-TB) regimen and verify eligibility for the 9-month regimen and therapeutic drug monitoring (TDM).

METHODS: We performed a retrospective chart review of patients with MDR-TB receiving standardised regimen at the German Nepal TB Project Clinic, Nepal, between 2014 and 2016. Eligibility for the 9-month regimen and indications for TDM were evaluated.

RESULTS: Out of 107 available patients' medical records, 98 were included. In this centre, the MDR-TB treatment success rates were 69.0% in 2015, 86.6% in 2016 and 86.5% in 2017. The median time to sputum smear conversion was 60 days (60-90 IQR) and culture conversion was 60 days (60-90 IQR). Observed side effects did not impact treatment outcomes. No difference in treatment success rates was observed between patients with predisposing risk factors and those without. Only 49% (36/74) of patients were eligible for the 9-month regimen and 23 patients for TDM according to American Thoracic Society guideline criteria.

CONCLUSIONS: Nepalese patients with MDR-TB on ambulatory care had good treatment outcome after programmatic treatment. Implementation of the new WHO oral MDR-TB treatment regimen may further improve treatment results. The 9-month regimen and TDM should be considered as part of programmatic care.

Original languageEnglish
Article numbere000606
Number of pages8
JournalBMJ open respiratory research
Volume7
Issue number1
Publication statusPublished - Aug-2020

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