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dc.contributor.authorBonilla, Cesar A.
dc.contributor.authorCrossa, Aldo
dc.contributor.authorJave, Hector O.
dc.contributor.authorJamanca, Ronal B.
dc.contributor.authorHerrera, Cesar
dc.contributor.authorAsencios, Luis
dc.contributor.authorMendoza, Alberto
dc.contributor.authorZignol, Matteo
dc.contributor.authorJaramillo, Ernesto
dc.contributor.authorMitnick, Carole Diane
dc.contributor.authorBayona, Jaime
dc.date.accessioned2010-12-09T20:20:10Z
dc.date.issued2008
dc.identifier.citationBonilla, 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.issn1932-6203en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:4621864
dc.description.abstractAim: 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.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pone.0002957en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2495032/pdf/en_US
dash.licenseLAA
dc.subjectinfectious diseasesen_US
dc.subjectantimicrobials and drug resistanceen_US
dc.subjectrespiratory infectionsen_US
dc.subjectpublic health and epidemiologyen_US
dc.subjectrespiratory medicineen_US
dc.titleManagement of Extensively Drug-Resistant Tuberculosis in Peru: Cure Is Possibleen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS ONEen_US
dash.depositing.authorMitnick, Carole Diane
dc.date.available2010-12-09T20:20:10Z
dash.affiliation.otherHMS^Global Health and Social Medicineen_US
dash.affiliation.otherHMS^Global Health and Social Medicineen_US
dc.identifier.doi10.1371/journal.pone.0002957*
dash.authorsorderedfalse
dash.contributor.affiliatedBayona, Jaime
dash.contributor.affiliatedMitnick, Carole


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