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

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

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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

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