Characteristics, management and outcome of patients with recurrent tuberculosis under routine programme conditions in Malawi


Salaniponi, FM; Nyirenda, TE; Kemp, JR; Squire, SB; Godfrey-Faussett, P; Harries, AD; (2003) Characteristics, management and outcome of patients with recurrent tuberculosis under routine programme conditions in Malawi. The international journal of tuberculosis and lung disease, 7 (10). pp. 948-52. ISSN 1027-3719

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Abstract

SETTING: All 43 non-private hospitals in Malawi, which registered TB cases between 1 July 1999 and 30 June 2000. OBJECTIVES: To determine 1) the characteristics, management and treatment outcome, 2) timing of the previous episode of TB, and 3) pattern of drug resistance in patients registered with recurrent smear-positive pulmonary TB. DESIGN: Retrospective data collection using TB registers and laboratory culture and drug sensitivity registers. RESULTS: There were 748 recurrent patients; data were available for 747. Of these, 487 (65%) successfully completed a re-treatment regimen, 185 (25%) died and the remainder had another outcome. Information about previous TB was recorded for 491 (66%) patients. In 286 (58%) there were 2 years or less between completing and re-starting treatment. Only 307 (41%) patients had sputum sent for culture and drug sensitivity tests. In 164 patients with cultures of Mycobacterium tuberculosis, 122 (81%) were fully sensitive, 25 (15%) had resistance to isoniazid and/or streptomycin, and 6 (4%) had resistance to isoniazid and rifampicin (MDR-TB). CONCLUSION: Patients with recurrent TB had acceptable treatment outcomes, and most had fully sensitive organisms. Over half had recurrent TB 2 years or less after completing treatment. Ways to prevent recurrence need to be investigated and implemented in the field.

Item Type: Article
Keywords: recurrent smear-positive TB, Malawi, human-immunodeficiency-virus, 2-year follow-up, cohort, resistance, relapse, trends, hiv
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Malaria Centre
PubMed ID: 14552564
Web of Science ID: 185659100006
URI: http://researchonline.lshtm.ac.uk/id/eprint/15859

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