Effectiveness of tuberculosis treatment in the pregnant tuberculosis patients versus those nonpregnant
https://doi.org/10.21292/2075-1230-2018-96-11-52-59
Abstract
The objective of the study: to compare the effectiveness of tuberculosis chemotherapy and treatment outcomes in the pregnant patients versus those nonpregnant.
Subjects and methods. Medical records of 218 HIV negative women ill with tuberculosis were analyzed: TB + Pregnancy Group included 109 pregnant tuberculosis patients; and TB Group included 109 nonpregnant female tuberculosis patients. The patients from TB Group were enrolled in order to match patients from TB + Pregnancy Group regarding the age, social status, specific features of the disease, lung tissue destruction, bacillary excretion, and drug resistance profile.
During treatment of tuberculosis, 72.5% (n = 79) of patients from the main group got pregnant. Pregnancy resulted in delivery in 67.0% (n = 73) of women, and in 23.0% (n = 25) of women, it was electively terminated before the 12th week of pregnancy.
First line drugs were prescribed to 55.0 and 42.2% of patients from Groups 1 and 2 (pχ2 > 0.05); combinations of first line and reserve drugs (due to resistance to isoniazid) were used in 22.0 and 37.6% (pχ2 > 0.05) respectively; and reserve drugs (due to MDR/XDR TB) were used in 22.9 and 23.9% (pχ2 > 0,05) of patients. The main course of tuberculosis treatment lasted for 11.6 ± 4.7 months in the pregnant patients and 14.3 ± 3.8 months in those nonpregnant. And pregnant patients had one forth part of their chemotherapy coinciding with their pregnancy.
Results: Only pregnant patients developed hepatotoxic reactions to anti-tuberculosis drugs. In HIV negative patients, treatment effectiveness was compatible in the pregnant and nonpregnant patients (58.7 ± 4.7 and 61.5 ± 4.7%, pχ2 > 0.05). Mortality due to progression of tuberculosis in the pregnant did not exceed the mortality in the nonpregnant ones (5.5 ± 2.2 and 7.4 ± 2.1%, pχ2 > 0.05). The frequency of relapses was the same in the pregnant women receiving anti-tuberculosis therapy and those nonpregnant (3.1 and 4.4%, pχ2 > 0.05).
About the Authors
Anna V. Nesterenko
Krasnoyarsk Regional TB Dispensary no. 1
Russian Federation
Deputy Head Doctor for Medical Activities.
26, 60 let Oktyabrya St., Krasnoyarsk, 660078.
Russian Federation
Deputy Head Doctor for Medical Activities.
26, 60 let Oktyabrya St., Krasnoyarsk, 660078.
Vera N. Zimina
People's Friendship University of Russia
Russian Federation
Doctor of Medical Sciences, Associate Professor at the Infectious Diseases Department with Training Courses in Epidemiology and Phthisiology of the Medical Institute.
6, Miklukho-Maklaya St., Moscow, 117198
Russian Federation
Doctor of Medical Sciences, Associate Professor at the Infectious Diseases Department with Training Courses in Epidemiology and Phthisiology of the Medical Institute.
6, Miklukho-Maklaya St., Moscow, 117198
Elena N. Beloborodova
People's Friendship University of Russia
Russian Federation
Assistant of the Infectious Diseases Department with Training Courses in Epidemiology and Phthisiology of the Medical Institute.
6, Miklukho-Maklaya St., Moscow, 117198
Russian Federation
Assistant of the Infectious Diseases Department with Training Courses in Epidemiology and Phthisiology of the Medical Institute.
6, Miklukho-Maklaya St., Moscow, 117198
Nataliya L. Karpina
Central Tuberculosis Research Institute
Russian Federation
Doctor of Medical Sciences, Head of Clinical Diagnostic Department.
2, Yauzskaya Alleya, Moscow, 107564
Russian Federation
Doctor of Medical Sciences, Head of Clinical Diagnostic Department.
2, Yauzskaya Alleya, Moscow, 107564
Svetlana I. Kayukova
Central Tuberculosis Research Institute
Russian Federation
Candidate of Medical Sciences, Senior Researcher of Phthisiology Department.
2, Yauzskaya Alleya, Moscow, 107564
Russian Federation
Candidate of Medical Sciences, Senior Researcher of Phthisiology Department.
2, Yauzskaya Alleya, Moscow, 107564
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For citations:
Nesterenko A.V., Zimina V.N., Beloborodova E.N., Karpina N.L., Kayukova S.I. Effectiveness of tuberculosis treatment in the pregnant tuberculosis patients versus those nonpregnant. Tuberculosis and Lung Diseases. 2018;96(11):52-59. (In Russ.) https://doi.org/10.21292/2075-1230-2018-96-11-52-59
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