Management of Extensively Drug-Resistant Tuberculosis in Peru: Cure Is Possible

Management of Extensively Drug-Resistant Tuberculosis in Peru: Cure Is Possible

DSpace/Manakin Repository

Management of Extensively Drug-Resistant Tuberculosis in Peru: Cure Is Possible

dc.contributor.author	Bonilla, Cesar A.
dc.contributor.author	Crossa, Aldo
dc.contributor.author	Jave, Hector O.
dc.contributor.author	Jamanca, Ronal B.
dc.contributor.author	Herrera, Cesar
dc.contributor.author	Asencios, Luis
dc.contributor.author	Mendoza, Alberto
dc.contributor.author	Zignol, Matteo
dc.contributor.author	Jaramillo, Ernesto
dc.contributor.author	Mitnick, Carole Diane
dc.contributor.author	Bayona, Jaime
dc.date.accessioned	2010-12-09T20:20:10Z
dc.date.issued	2008
dc.identifier.citation	Bonilla, Cesar A., Aldo Crossa, Hector O. Jave, Carole D. Mitnick, Ronal B. Jamanca, Cesar Herrera, Luis Asencios, et al. 2008. Management of extensively drug-resistant tuberculosis in Peru: cure is possible. PLoS ONE 3(8): e2957.	en_US
dc.identifier.issn	1932-6203	en_US
dc.identifier.uri	http://nrs.harvard.edu/urn-3:HUL.InstRepos:4621864
dc.description.abstract	Aim: To describe the incidence of extensive drug-resistant tuberculosis (XDR-TB) reported in the Peruvian National multidrug-resistant tuberculosis (MDR-TB) registry over a period of more than ten years and present the treatment outcomes for a cohort of these patients. Methods: From the Peruvian MDR-TB registry we extracted all entries that were approved for second-line anti-TB treatment between January 1997 and June of 2007 and that had Drug Susceptibility Test (DST) results indicating resistance to both rifampicin and isoniazid (i.e. MDR-TB) in addition to results for at least one fluoroquinolone and one second-line injectable (amikacin, capreomycin and kanamycin). Results: Of 1,989 confirmed MDR-TB cases with second-line DSTs, 119(6.0%) XDR-TB cases were detected between January 1997 and June of 2007. Lima and its metropolitan area account for 91% of cases, a distribution statistically similar to that of MDR-TB. A total of 43 XDR-TB cases were included in the cohort analysis, 37 of them received ITR. Of these, 17(46%) were cured, 8(22%) died and 11(30%) either failed or defaulted treatment. Of the 14 XDR-TB patients diagnosed as such before ITR treatment initiation, 10 (71%) were cured and the median conversion time was 2 months. Conclusion: In the Peruvian context, with long experience in treating MDR-TB and low HIV burden, although the overall cure rate was poor, a large proportion of XDR-TB patients can be cured if DST to second-line drugs is performed early and treatment is delivered according to the WHO Guidelines.	en_US
dc.language.iso	en_US	en_US
dc.publisher	Public Library of Science	en_US
dc.relation.isversionof	doi:10.1371/journal.pone.0002957	en_US
dc.relation.hasversion	http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2495032/pdf/	en_US
dash.license	LAA
dc.subject	infectious diseases	en_US
dc.subject	antimicrobials and drug resistance	en_US
dc.subject	respiratory infections	en_US
dc.subject	public health and epidemiology	en_US
dc.subject	respiratory medicine	en_US
dc.title	Management of Extensively Drug-Resistant Tuberculosis in Peru: Cure Is Possible	en_US
dc.type	Journal Article	en_US
dc.description.version	Version of Record	en_US
dc.relation.journal	PLoS ONE	en_US
dash.depositing.author	Mitnick, Carole Diane
dc.date.available	2010-12-09T20:20:10Z
dash.affiliation.other	HMS^Global Health and Social Medicine	en_US
dash.affiliation.other	HMS^Global Health and Social Medicine	en_US