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

PLoS One. 2020 Aug 4;15(8):e0236264. doi: 10.1371/journal.pone.0236264. eCollection 2020.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anemia / chemically induced
  • Anemia / epidemiology
  • Antitubercular Agents / administration & dosage*
  • Antitubercular Agents / adverse effects
  • Cost of Illness
  • Democratic Republic of the Congo / epidemiology
  • Diarylquinolines / administration & dosage*
  • Diarylquinolines / adverse effects
  • Drug Administration Schedule
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / methods
  • Exanthema / chemically induced
  • Exanthema / epidemiology
  • Extensively Drug-Resistant Tuberculosis / drug therapy*
  • Extensively Drug-Resistant Tuberculosis / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peripheral Nervous System Diseases / chemically induced
  • Peripheral Nervous System Diseases / epidemiology
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Vomiting / chemically induced
  • Vomiting / epidemiology
  • Young Adult

Substances

  • Antitubercular Agents
  • Diarylquinolines
  • bedaquiline

Associated data

  • Dryad/10.5061/dryad.cnp5hqc29

Grants and funding

This work received a support of Action Damian Foundation for Hospitalization of All XDR and preXDR patients and USAID for de transport support during decentralization approach.