Evidence map›Paper›PMID 26506854›Full record

Observational studyThorax2015

Achieving high treatment success for multidrug-resistant TB in Africa: initiation and scale-up of MDR TB care in Ethiopia--an observational cohort study.

Daniel Meressa, Rocío M Hurtado, Jason R Andrews, Ermias Diro, Kassim Abato, Tewodros Daniel, Paritosh Prasad, Rebekah Prasad, Bekele Fekade, Yared Tedla and 9 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Thorax, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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  3. The prevalence of pulmonary hypertension in post-tuberculosis and active tuberculosis populations: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2024
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  9. Linezolid for drug-resistant pulmonary tuberculosis.The Cochrane database of systematic reviews · 2019
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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Daniel MeressaGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia St. Peter's Tuberculosis Specialized Hospital, Addis Ababa, Ethiopia.
Rocío M HurtadoGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA.
Jason R AndrewsDivision of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA.
Ermias DiroGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia University of Gondar Hospital, Gondar, Ethiopia.
Kassim AbatoGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia.
Tewodros DanielGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia.
Paritosh PrasadGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia Current affiliation: Pulmonary and Critical Care Medicine Division, University of Rochester Medical Center, Rochester, New York, USA.
Rebekah PrasadGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia Current affiliation: Pediatrics Department, University of Rochester Medical Center, Rochester, New York, USA.
Bekele FekadeGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia.
Yared TedlaSt. Peter's Tuberculosis Specialized Hospital, Addis Ababa, Ethiopia.
Hanan YusufGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia University of Gondar Hospital, Gondar, Ethiopia.
Melaku TadesseGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia.
Dawit TeferaGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia University of Gondar Hospital, Gondar, Ethiopia.
Abraham AshenafiGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia.
Girma DestaGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia.
Getachew AderayeHallelujah Clinic, Addis Ababa, Ethiopia.
Kristian OlsonGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.
Sok ThimGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia Cambodian Health Committee, Phnom Penh, Cambodia.
Anne E GoldfeldGlobal Health Committee and Zahara Children's Program, Addis Ababa, Ethiopia Cambodian Health Committee, Phnom Penh, Cambodia Program in Cellular and Molecular Medicine, Children's Hospital Boston, Boston, Massachusetts, USA.

Funding

Network Models for Evaluating HIV-associated MDR TB transmission and controlK01AI104411 · NIAID · STANFORD UNIVERSITY · PI ANDREWS, JASON RANDOLPH · 2013 to 2016
$549k
NIAID NIH HHS K01 AI104411
6 · The paper itself

Abstract

backgroundIn Africa, fewer than half of patients receiving therapy for multidrug-resistant TB (MDR TB) are successfully treated, with poor outcomes reported for HIV-coinfected patients.

methodsA standardised second-line drug (SLD) regimen was used in a non-governmental organisation-Ministry of Health (NGO-MOH) collaborative community and hospital-based programme in Ethiopia that included intensive side effect monitoring, adherence strategies and nutritional supplementation. Clinical outcomes for patients with at least 24 months of follow-up were reviewed and predictors of treatment failure or death were evaluated by Cox proportional hazards models.

resultsFrom February 2009 to December 2014, 1044 patients were initiated on SLD. 612 patients with confirmed or presumed MDR TB had ≥ 24 months of follow-up, 551 (90.0%) were confirmed and 61 (10.0%) were suspected MDR TB cases. 603 (98.5%) had prior TB treatment, 133 (21.7%) were HIV coinfected and median body mass index (BMI) was 16.6. Composite treatment success was 78.6% with 396 (64.7%) cured, 85 (13.9%) who completed treatment, 10 (1.6%) who failed, 85 (13.9%) who died and 36 (5.9%) who were lost to follow-up. HIV coinfection (adjusted HR (AHR): 2.60, p<0.001), BMI (AHR 0.88/kg/m(2), p=0.006) and cor pulmonale (AHR 3.61, p=0.003) and confirmed MDR TB (AHR 0.50, p=0.026) were predictive of treatment failure or death.

conclusionsWe report from Ethiopia the highest MDR TB treatment success outcomes so far achieved in Africa, in a setting with severe resource constraints and patients with advanced disease. Intensive treatment of adverse effects, nutritional supplementation, adherence interventions and NGO-MOH collaboration were key strategies contributing to success. We argue these approaches should be routinely incorporated into programmes.

Indexed as

AdultCoinfectionEthiopiaFemaleHIV InfectionsHumansMaleMedication AdherenceProportional Hazards ModelsTreatment OutcomeTuberculosis, Multidrug-ResistantYoung AdultTuberculosis

Identifiers

PMID26506854
PMCPMC4680185

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.