PT  - JOURNAL ARTICLE
AU  - Yana Batyrshina
AU  - Tatyana Petrenko
TI  - Effectiveness of national standardized and WHO regimens and risk factors of unfavorable outcomes in treatment of patients with MDR-TB in Novosibirsk Oblast, Russian Federation
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P2615
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P2615.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P2615.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background: High prevalence of MDR-TB in Novosibirsk Oblast (NO) (61,0 on 100000 population in 2012) requires for search of optimal treatment regimens for these patients.Aims: To evaluate outcomes of MDR-TB treatment with use of WHO regimens and 4th regimen of national standard of MDR-TB therapy. To define risk factors (RF) of unfavorable outcomes.Methods: Retrospective cohort study. The sample is –341 patients with newly diagnosed MDR-TB, residents of NO, treated with use of mentioned regimens in 2005-2010. Outcomes were defined after completed treatment course as a cure (culture conversion) and unfavorable (failure, death) with follow-up time 1-3 years in 202 patients. Collected clinical and socio-demographic patients' data were evaluated for potential RF of unfavorable outcomes by odds ratio (OR) with 95%CI calculation.Results: 268(78,6%) patients were cured, 14(4,1%) died during treatment and 59(17,3%) had treatment failure. Relapses occurred in 14 of 146 cured (9,6%), 9 of 56 patients with treatment failure (16,1%) died during follow-up time. RF of unfavorable outcomes were: smear positivity (OR 3,0(1,7-5,3), p=0,0001), pulmonary lesions > 2 segments (OR 5,7(2,8-11,5), p<0,0001), pre-XDR (OR 2,3(1,3-4,0), p=0,003), treatment interruptions (OR 4,4(2,4-8,0), p<0,0001), alcoholism (OR 2,4(1,3-4,1), p=0,006), unemployment (OR 1,8(1,1-3,1), p=0,03), rural residence (OR 2,2(1,3-3,7), p=0,003).Conclusions: Treatment outcomes depend on severity of TB process and patient adherence to therapy and may be improved by early TB diagnostics and increasing tolerance especiallyamong socially maladjusted patients.