Treatment outcomes among patients with isoniazid mono-resistant tuberculosis in Mumbai, India: A retrospective cohort study
Background: Tuberculosis (TB) remains a significant cause of mortality globally, with India accounting for 27% of the estimated number of people with TB. Multidrug-resistant TB (MDR-TB) and isoniazid (INH) resistance pose additional challenges to effective treatment. We aimed to describe treatment o...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405579424000688 |
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| author | Sumaiya Khan Arunima Silsarma Raman Mahajan Shahid Khan Praveen Davuluri Narendra Sutar Aparna Iyer Shubhangi Mankar Vikas Oswal Varsha Puri Daksha Shah Vijay Chavan Hannah Spencer Petros Isaakidis |
| author_facet | Sumaiya Khan Arunima Silsarma Raman Mahajan Shahid Khan Praveen Davuluri Narendra Sutar Aparna Iyer Shubhangi Mankar Vikas Oswal Varsha Puri Daksha Shah Vijay Chavan Hannah Spencer Petros Isaakidis |
| author_sort | Sumaiya Khan |
| collection | DOAJ |
| description | Background: Tuberculosis (TB) remains a significant cause of mortality globally, with India accounting for 27% of the estimated number of people with TB. Multidrug-resistant TB (MDR-TB) and isoniazid (INH) resistance pose additional challenges to effective treatment. We aimed to describe treatment outcomes of INH mono-resistant TB patients under programmatic conditions in Mumbai, India. Methods: This retrospective cohort study was conducted at Shatabdi Hospital in Mumbai between 2019–2021.We described the clinical and demographic characteristics, treatment outcomes, and risk factors for unfavourable outcomes among patients with INH mono-resistant TB treated with rifampicin, ethambutol, pyrazinamide, and levofloxacin (LfxREZ) for a duration of 6 months. Results: Among 3105 patients with drug-resistant TB initiated on treatment, 217 (7 %) had INH mono-resistant TB. Of these, 54 % (117/217) were female, with a median age of 26 years (interquartile range: 20–40). The majority (88 %; 191/217) presented with pulmonary TB, and most (87 %; 188/217) had favourable treatment outcomes, including treatment completion (52 %; 112/217) and cure (35 %; 76/217). Unfavourable outcomes, including treatment failure (2.3 %; 5/217), loss to follow-up (9.2 %; 20/217), or death (1.8 %; 4/217), were observed in 13 % (29/217) of patients. A total of ten (5 %) patients experienced at least one non-severe adverse drug reaction. Factors associated with unfavourable outcomes included severe thinness (p = 0.019) and male gender (p = 0.012). Conclusion: Treating INH mono-resistant patients with LfxREZ resulted in satisfactory outcomes and low toxicity. It is important to rule out drug resistance to INH while determining the treatment regimen. |
| format | Article |
| id | doaj-art-2d02503c409b418db435c3ff4a37c198 |
| institution | OA Journals |
| issn | 2405-5794 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| spelling | doaj-art-2d02503c409b418db435c3ff4a37c1982025-08-20T02:34:19ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942024-12-013710048110.1016/j.jctube.2024.100481Treatment outcomes among patients with isoniazid mono-resistant tuberculosis in Mumbai, India: A retrospective cohort studySumaiya Khan0Arunima Silsarma1Raman Mahajan2Shahid Khan3Praveen Davuluri4Narendra Sutar5Aparna Iyer6Shubhangi Mankar7Vikas Oswal8Varsha Puri9Daksha Shah10Vijay Chavan11Hannah Spencer12Petros Isaakidis13Médecins Sans Frontières, Mumbai, IndiaMédecins Sans Frontières, Mumbai, IndiaMédecins Sans Frontières, Mumbai, IndiaMédecins Sans Frontières, Mumbai, IndiaMédecins Sans Frontières, Mumbai, IndiaNational Tuberculosis Elimination Program, Mumbai, IndiaMédecins Sans Frontières, Mumbai, IndiaNational Tuberculosis Elimination Program, Mumbai, IndiaNational Tuberculosis Elimination Program, Mumbai, IndiaPublic Health Department, Municipal Corporation of Greater Mumbai, Mumbai, IndiaPublic Health Department, Municipal Corporation of Greater Mumbai, Mumbai, IndiaMédecins Sans Frontières, Mumbai, IndiaMédecins Sans Frontières, Southern Africa Medical Unit, Cape Town, South AfricaMédecins Sans Frontières, Southern Africa Medical Unit, Cape Town, South Africa; Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; Corresponding author.Background: Tuberculosis (TB) remains a significant cause of mortality globally, with India accounting for 27% of the estimated number of people with TB. Multidrug-resistant TB (MDR-TB) and isoniazid (INH) resistance pose additional challenges to effective treatment. We aimed to describe treatment outcomes of INH mono-resistant TB patients under programmatic conditions in Mumbai, India. Methods: This retrospective cohort study was conducted at Shatabdi Hospital in Mumbai between 2019–2021.We described the clinical and demographic characteristics, treatment outcomes, and risk factors for unfavourable outcomes among patients with INH mono-resistant TB treated with rifampicin, ethambutol, pyrazinamide, and levofloxacin (LfxREZ) for a duration of 6 months. Results: Among 3105 patients with drug-resistant TB initiated on treatment, 217 (7 %) had INH mono-resistant TB. Of these, 54 % (117/217) were female, with a median age of 26 years (interquartile range: 20–40). The majority (88 %; 191/217) presented with pulmonary TB, and most (87 %; 188/217) had favourable treatment outcomes, including treatment completion (52 %; 112/217) and cure (35 %; 76/217). Unfavourable outcomes, including treatment failure (2.3 %; 5/217), loss to follow-up (9.2 %; 20/217), or death (1.8 %; 4/217), were observed in 13 % (29/217) of patients. A total of ten (5 %) patients experienced at least one non-severe adverse drug reaction. Factors associated with unfavourable outcomes included severe thinness (p = 0.019) and male gender (p = 0.012). Conclusion: Treating INH mono-resistant patients with LfxREZ resulted in satisfactory outcomes and low toxicity. It is important to rule out drug resistance to INH while determining the treatment regimen.http://www.sciencedirect.com/science/article/pii/S2405579424000688TuberculosisINH mono-resistantIsoniazid resistanceDrug resistanceIndia |
| spellingShingle | Sumaiya Khan Arunima Silsarma Raman Mahajan Shahid Khan Praveen Davuluri Narendra Sutar Aparna Iyer Shubhangi Mankar Vikas Oswal Varsha Puri Daksha Shah Vijay Chavan Hannah Spencer Petros Isaakidis Treatment outcomes among patients with isoniazid mono-resistant tuberculosis in Mumbai, India: A retrospective cohort study Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Tuberculosis INH mono-resistant Isoniazid resistance Drug resistance India |
| title | Treatment outcomes among patients with isoniazid mono-resistant tuberculosis in Mumbai, India: A retrospective cohort study |
| title_full | Treatment outcomes among patients with isoniazid mono-resistant tuberculosis in Mumbai, India: A retrospective cohort study |
| title_fullStr | Treatment outcomes among patients with isoniazid mono-resistant tuberculosis in Mumbai, India: A retrospective cohort study |
| title_full_unstemmed | Treatment outcomes among patients with isoniazid mono-resistant tuberculosis in Mumbai, India: A retrospective cohort study |
| title_short | Treatment outcomes among patients with isoniazid mono-resistant tuberculosis in Mumbai, India: A retrospective cohort study |
| title_sort | treatment outcomes among patients with isoniazid mono resistant tuberculosis in mumbai india a retrospective cohort study |
| topic | Tuberculosis INH mono-resistant Isoniazid resistance Drug resistance India |
| url | http://www.sciencedirect.com/science/article/pii/S2405579424000688 |
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