ArticlePloS one2014
Intensive-phase treatment outcomes among hospitalized multidrug-resistant tuberculosis patients: results from a nationwide cohort in Nigeria.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Retention in Care Among People Living with HIV in Nigeria: A Systematic Review and Meta-analysis.Journal of research in health sciences · 2024Pooled it
- The effects of MDR/RR-TB treatment on HIV disease: A systematic review of literature.PloS one · 2021Pooled it
- Comorbidities and treatment outcomes in multidrug resistant tuberculosis: a systematic review and meta-analysis.Scientific reports · 2018Pooled it
- Multidrug-resistant tuberculosis (MDR-TB): an evolving threat to the Nigerian health system - a review.Annals of medicine and surgery (2012) · 2026Review
- High rates of culture conversion and low loss to follow-up in MDR-TB patients managed at Regional Referral Hospitals in Uganda.BMC infectious diseases · 2021Article
- Repurposing Immunomodulatory Drugs to Combat Tuberculosis.Frontiers in immunology · 2021Review
- Factors influencing the length of hospital stay during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara regional state hospitals, Ethiopia: a retrospective follow up study.BMC public health · 2020Article
- Addressing the drug-resistant tuberculosis challenge through implementing a mixed model of care in Uganda.PloS one · 2020Article
- Successful expansion of community-based drug-resistant TB care in rural Eswatini - a retrospective cohort study.Tropical medicine & international health : TM & IH · 2019Article
- Intensive phase treatment outcome and associated factors among patients treated for multi drug resistant tuberculosis in Ethiopia: a retrospective cohort study.BMC infectious diseases · 2019Article
- Models for Predicting Time to Sputum Conversion Among Multi-Drug Resistant Tuberculosis Patients in Lagos, South-West Nigeria.Frontiers in public health · 2018Article
- Article
- The experience of scaling up a decentralized, ambulatory model of care for management of multidrug-resistant tuberculosis in two regions of Ethiopia.Journal of clinical tuberculosis and other mycobacterial diseases · 2017Article
- High mortality among tuberculosis patients on treatment in Nigeria: a retrospective cohort study.BMC infectious diseases · 2017Article
- Hospitalized care for MDR-TB in Port Harcourt, Nigeria: a qualitative study.BMC infectious diseases · 2017Article
- Repurposing and Revival of the Drugs: A New Approach to Combat the Drug Resistant Tuberculosis.Frontiers in microbiology · 2017Article
- Smear grading and the Mantoux skin test can be used to predict sputum smear conversion in patients suffering from tuberculosis.GMS hygiene and infection control · 2017Article
- Infection Control for Drug-Resistant Tuberculosis: Early Diagnosis and Treatment Is the Key.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Article
- Psychosocial wellbeing of patients with multidrug resistant tuberculosis voluntarily confined to long-term hospitalisation in Nigeria.BMJ global health · 2016Article
- Map the gap: missing children with drug-resistant tuberculosis.Public health action · 2015Article
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Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNigeria is faced with a high burden of Human Immunodeficiency Virus (HIV) infection and multidrug-resistant tuberculosis (MDR-TB). Treatment outcomes among MDR-TB patients registered across the globe have been poor, partly due to high loss-to-follow-up. To address this challenge, MDR-TB patients in Nigeria are hospitalized during the intensive-phase(IP) of treatment (first 6-8 months) and are provided with a package of care including standardized MDR-TB treatment regimen, antiretroviral therapy (ART) and cotrimoxazole prophylaxis (CPT) for HIV-infected patients, nutritional and psychosocial support. In this study, we report the end-IP treatment outcomes among them.
methodsIn this retrospective cohort study, we reviewed the patient records of all bacteriologically-confirmed MDR-TB patients admitted for treatment between July 2010 and October 2012.
resultsOf 162 patients, 105(65%) were male, median age was 34 years and 28(17%) were HIV-infected; all 28 received ART and CPT. Overall, 138(85%) were alive and culture negative at the end of IP, 24(15%) died and there was no loss-to-follow-up. Mortality was related to low CD4-counts at baseline among HIV-positive patients. The median increase in body mass index among those documented to be underweight was 2.6 kg/m2 (p<0.01) and CD4-counts improved by a median of 52 cells/microL among the HIV-infected patients (p<0.01).
conclusionsEnd-IP treatment outcomes were exceptional compared to previously published data from international cohorts, thus confirming the usefulness of a hospitalized model of care. However, less than five percent of all estimated 3600 MDR-TB patients in Nigeria were initiated on treatment during the study period. Given the expected scale-up of MDR-TB care, the hospitalized model is challenging to sustain and the national TB programme is contemplating to move to ambulatory care. Hence, we recommend using both ambulatory and hospitalized approaches, with the latter being reserved for selected high-risk groups.
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