Simulation of Conditions and Results of Implementation of Short-Course Treatment Regimes in Tuberculosis Patients
https://doi.org/10.58838/2075-1230-2023-101-6-8-12
Abstract
The objective: to study the conditions of implementation of short-course (4 and 9 months) treatment regimens in tuberculosis patients and simulate their impact on the frequency of early treatment interruption (ETI) by patients.
Subjects and Methods. Data on the treatment duration from enrollment to chemotherapy interruption in 8,029 tuberculosis patients were studied. Data were obtained from the Federal Register of Tuberculosis Cases for 2020. Of these, 3,379 patients were treated with regimens for susceptible or suspected susceptible tuberculous mycobacteria excluding isoniazid resistant tuberculosis, and 4,650 patients received regimens for rifampicin-resistant tuberculous mycobacteria.
Results. The median duration of treatment from onset to ETI was 124 (95% CI 120-128) days in 3,379 patients, 224 (95% CI 215-233) days in 4,650 patients, or 170 (95% CI 157-181) days if there was a history of treatment interruption. Simulation of ETI terms when short-course chemotherapy regimens were introduced has shown that we can expect a 2-fold decrease in the proportion of patients who interrupted chemotherapy among patients with preserved/suspected susceptibility of tuberculous mycobacteria, and 1.3-1.7-fold decrease among patients with confirmed/presumed drug resistance of tuberculous mycobacteria at least to rifampicin.
About the Authors
V. S. Burykhin
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Valery S. Burykhin, Physician Responsible for Statistics and Reporting,
Center of Socially Important Infections
4 Dostoevsky St., Moscow, 127473
Phone:+7 (495) 681-11-66
I. A. Vasilyeva
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Irina A. Vasilyeva, Doctor of Medical Sciences, Professor, Director, Head of Phthisiology Department Pirogov Russian National Research Medical University, Russian Ministry of Health
4 Dostoevsky St., Moscow, 127473
Phone:+7 (495) 681-11-66
S. A. Sterlikov
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Sergey A. Sterlikov, Doctor of Medical Sciences, Head of Department
for Tuberculosis and HIV Epidemiology and Monitoring
4 Dostoevsky St., Moscow, 127473
Phone:+7 (495) 681-11-66
V. V. Testov
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Vadim V. Testov, Candidate of Medical Sciences, Deputy Director for Statistics and Reporting
4 Dostoevsky St., Moscow, 127473
Phone:+7 (495) 681-11-66
V. G. Kudrina
Russian Medical Academy of On-going Professional Education, Russian Ministry of Health
Russian Federation
Russian Federation
Valentina G. Kudrina, Doctor of Medical Sciences, Professor, Head of Department of Medical Statistics and Digital Health Care
2/1, Build. 1. Barrikadnaya St., Moscow, 125993
Phone: +7 (495) 680-05-99
N. D. Urushadze
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Natalia D. Urushadze, Junior Researcher of Infectious Pathology Department
4 Dostoevsky St., Moscow, 127473
Phone:+7 (495) 681-11-66
References
1. Baryery v dostupe k lecheniyu tuberkuleza glazami patsiyentov, zhivushchikh s VICH-infektsiyey i tuberkulezom v Rossii. [Barriers to accessing treatment of tuberculosis from the point of view of HIV-infected patients in Russia]. Available: https://evanetwork.ru/wp-content/uploads/2015/06/Bareryi-v-dostupe-k-lecheniyu-tu berkul eza-glazami-patsientov-zhivushhih-s-VICH_1.pdf. Accessed: 18.07.2023 г.
2. Vasilyeva I.A., Sterlikov S.A., Testov V.V., Mikhaylova Yu.V., Obukhova O.V., Ponomarev S.B., Kudlay D.A. Otraslevye i ekonomicheskiye pokazateli protivotuberkulyoznoy raboty v 2019-2020 gg. Statisticheskiye materialy. [Sectoral and economic rates of tuberculosis control in 2019-2020. Statistic materials]. Moscow, FGBU NMITS FPI Minzdrava Rossii Publ., 2022, 64 p.
3. Maryandyshev A.O., Kulizhskaya A.I., Khimova E.S., Perkhin D.V., Sveshnikova O.M., Presnova S.E., Kurochkina N.P., Sotnikov A.S., Lesheva N.A., Vasilyeva I.A. Short course treatment regimens for multiple drug resistant tuberculosis in Arkhangelsk, Murmansk and Belgorod Regions. Tuberculosis and Lung Diseases, 2019, vol. 97, no. 7, pp. 5-10. (In Russ.) https://doi.org/10.21292/2075-1230-2019-97-7-5-10.
4. Ungureanu T.N., Grzhibovskiy A.M. Comparison of three or more independent groups using the nonparametric Kraskell-Wallis criterion in the STATA program. Ekologiya Cheloveka, 2014, no. 6, pp. 55-58. (In Russ.)
5. Shurygin A.A., Makarova E.A. The effect of early treatment interruption on treatment efficacy. Mediko-Farmatsevticheskiy Journal Puls, 2021, vol. 23, no. 9, pp. 136-141. (In Russ.)
6. Horter S., Achar J., Gray N., Parpieva N., Tigay Z., Singh J., & Stringer, B. (2020). Patient and health-care worker perspectives on the short-course regimen for treatment of drug-resistant tuberculosis in Karakalpakstan, Uzbekistan // PLoS ONE. – 2020. – Vol.15, № 11:e0242359. https://doi.org/10.1371/journal.pone.0242359
7. O’Donnell M. R., Wolf A., Werner L., Horsburgh C. R., & Padayatchi, N. Adherence in the treatment of patients with extensively drug-resistant tuberculosis and HIV in South Africa: A prospective cohort study // Journal of Acquired Immune Deficiency Syndromes. – 2019. – Vol.67, № 1. – Р. 22–29. https://doi.org/10.1097/QAI.0000000000000221
8. Silva D.R, Mello FC.Q, Migliori G.B. Shortened tuberculosis treatment regimens: what is new?// J Bras Pneumol. – 2020. – Vol.46, №2 :e20200009. https://doi.org/10.36416/1806-3756/e20200009.
9. Tuberculosis surveillance and monitoring in Europe 2023 (2021 data): 145 p. https://doi.org/10.2900/637206.
10. WHO consolidated guidelines on tuberculosis: module 4: treatment: drug-susceptible tuberculosis treatment. Availabie at: https://www.who.int/publications/i/item/9789240007048 [Accessed Sep 10, 2023]
11. WHO consolidated guidelines on tuberculosis. Module 4: treatment – drug-resistant tuberculosis treatment, 2022. Availabie at: https://www.who.int/publications/i/item/9789240063129[Accessed Okt 20, 2023]
Review
For citations:
Burykhin V.S., Vasilyeva I.A., Sterlikov S.A., Testov V.V., Kudrina V.G., Urushadze N.D. Simulation of Conditions and Results of Implementation of Short-Course Treatment Regimes in Tuberculosis Patients. Tuberculosis and Lung Diseases. 2023;101(6):8-12. (In Russ.) https://doi.org/10.58838/2075-1230-2023-101-6-8-12
Views:
626
Email this article 