These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Treatment outcomes for multidrug-resistant tuberculosis under DOTS-Plus: a systematic review and meta-analysis of published studies.
    Author: Kibret KT, Moges Y, Memiah P, Biadgilign S.
    Journal: Infect Dis Poverty; 2017 Jan 17; 6(1):7. PubMed ID: 28093078.
    Abstract:
    BACKGROUND: Anti-tuberculosis drug resistance is a major public health problem that threatens the progress made in tuberculosis care and control worldwide. Treatment success rates of multidrug-resistant tuberculosis (MDR-TB) is a key issue that cannot be ignored. There is a paucity of evidence that assessed studies on the treatment of MDR-TB, which focus on the effectiveness of the directly observed treatment, short-course (DOTS)-Plus program. Therefore, it is crucial to assess and summarize the overall treatment outcomes for MDR-TB patients enrolled in the DOTS-Plus program in recent years. The purpose of this study was to thus assess and summarize the available evidence for MDR-TB treatment outcomes under DOTS-Plus. METHODS: A systematic review and meta-analysis of published literature was conducted. Original studies were identified using the databases MEDLINE®/PubMed®, Hinari, and Google Scholar. Heterogeneity across studies was assessed using the Cochran's Q test and I2 statistic. Pooled estimates of treatment outcomes were computed using the random effect model. RESULTS: Based on the 14 observational studies included in the meta-analysis, it was determined that 5 047 patients reported treatment outcomes. Of these, the pooled prevalence, 63.5% (95% CI: 58.4-68.5%) successfully completed full treatment (cured or treatment completed) with a pooled cure rate of 55.6%, whereas 12.6% (95% CI: 9.0-16.2%) of the patients died, 14.2% (95% CI: 11.6-16.8%) defaulted from therapy, and 7.6% (95% CI: 5.6-9.7%) failed therapy. Overall 35.4% (95% CI: 30-40.8%) of patients had unsuccessful treatment outcomes. An unsatisfactorily high percentage 43% (95% CI: 32-54%) of unsuccessful treatment outcomes was observed among patients who were enrolled in standardized treatment regimens. CONCLUSION: This study revealed that patients with MDR-TB exhibited a very low treatment success rate compared to the World Health Organization 2015 target of at least 75 to 90%. The high default rate observed by conducting this literature review could possibly explain the spread of the MDR-TB strain in various populations. A better treatment success rate was observed among patients in individualized treatment regimens than in standardized ones. Conducting further individual-based meta-analysis is recommended to identify potential factors for defaulting treatment using large-scale and multi-center studies.
    [Abstract] [Full Text] [Related] [New Search]