ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Prevalence, Predictors, and Successful Treatment Outcomes of Xpert MTB/RIF-identified Rifampicin-resistant Tuberculosis in Post-conflict Eastern Democratic Republic of the Congo, 2012-2017: A Retrospective Province-Wide Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pretreatment attrition after rifampicin-resistant tuberculosis diagnosis with Xpert MTB/RIF or ultra in high TB burden countries: a systematic review and meta-analysis.BMJ global health · 2025Pooled it
- Accuracy of Xpert MTB/RIF assay for the diagnosis of tuberculous pleural effusion.Journal of clinical laboratory analysis · 2022Pooled it
- Differential yield of universal versus selective drug susceptibility testing of patients with tuberculosis in high-burden countries: a systematic review and meta-analysis.BMJ global health · 2020Pooled it
- Delayed diagnosis of patients with rifampicin-resistant tuberculosis and its associated factors in a high tuberculosis endemic area Guizhou, China.BMC infectious diseases · 2026Article
- Drug-Resistant Tuberculosis Outcomes in South Kivu Province, Democratic Republic of Congo, During a Humanitarian Crisis (2018-2024).Open forum infectious diseases · 2026Article
- Drug-resistant tuberculosis in war and complex emergencies: jeopardising progress towards TB elimination and antimicrobial resistance control - a scoping review and perspective.BMJ global health · 2026Article
- Determinants of treatment success and cost implications in MDR/RR-TB patients: a prospective cohort study in China.Scientific reports · 2025Article
- Rifampicin-resistantJournal of clinical tuberculosis and other mycobacterial diseases · 2025Article
- Prevalence of drug-resistant Mycobacterium tuberculosis and its associated factors among tuberculosis patients attending Dilla university referral hospital, Ethiopia.BMC infectious diseases · 2025Article
- Prevalence of Rifampicin resistance tuberculosis among presumptive tuberculosis patients in Egypt-2021: a national health facility-based survey.BMC infectious diseases · 2024Article
- Rifampin Mono-Resistant Tuberculosis in New York City, 2010-2021: A Retrospective Case Series.Open forum infectious diseases · 2023Article
- Review
- Successful outcomes for patients with drug-resistant tuberculosis despite civil unrest and COVID-19 in Haiti.PLOS global public health · 2023Article
- GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019.African journal of laboratory medicine · 2022Article
- Global Tuberculosis Report 2020 - Reflections on the Global TB burden, treatment and prevention efforts.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2021Article
- Xpert Mycobacterium tuberculosis/Rifampicin-Detected Rifampicin Resistance is a Suboptimal Surrogate for Multidrug-resistant Tuberculosis in Eastern Democratic Republic of the Congo: Diagnostic and Clinical Implications.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Telomere length and outcome of treatment for pulmonary tuberculosis in a gold mining community.Scientific reports · 2021Article
- Discordant line probe genotypic testing vs culture-based drug susceptibility phenotypic testing in TB endemic KwaZulu-Natal: Impact on bedside clinical decision making.Journal of clinical tuberculosis and other mycobacterial diseases · 2020Article
- Delayed recognition of Ebola virus disease is associated with longer and larger outbreaks.Emerging microbes & infections · 2020Article
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Authors and funding
21 authors.
Funding
Abstract
backgroundMultidrug-resistant tuberculosis (MDR-TB) jeopardizes global TB control. The prevalence and predictors of Rifampicin-resistant (RR) TB, a proxy for MDR-TB, and the treatment outcomes with standard and shortened regimens have not been assessed in post-conflict regions, such as the South Kivu province in the eastern Democratic Republic of the Congo (DRC). We aimed to fill this knowledge gap and to inform the DRC National TB Program.
methodsof adults and children evaluated for pulmonary TB by sputum smear microscopy and Xpert MTB/RIF (Xpert) from February 2012 to June 2017. Multivariable logistic regression, Kaplan-Meier estimates, and multivariable Cox regression were used to assess independent predictors of RR-TB and treatment failure/death.
resultsOf 1535 patients Xpert-positive for TB, 11% had RR-TB. Independent predictors of RR-TB were a positive sputum smear (adjusted odds ratio [aOR] 2.42, 95% confidence interval [CI] 1.63-3.59), retreatment of TB (aOR 4.92, 95% CI 2.31-10.45), and one or more prior TB episodes (aOR 1.77 per episode, 95% CI 1.01-3.10). Over 45% of RR-TB patients had no prior TB history or treatment. The median time from Xpert diagnosis to RR-TB treatment initiation was 12 days (interquartile range 3-60.2). Cures were achieved in 30/36 (83%) and 84/114 (74%) of patients on 9- vs 20/24-month MDR-TB regimens, respectively (P = .06). Predictors of treatment failure/death were the absence of directly observed therapy (DOT; adjusted hazard ratio [aHR] 2.77, 95% CI 1.2-6.66) and any serious adverse drug event (aHR 4.28, 95% CI 1.88-9.71).
conclusionsFavorable RR-TB cure rates are achievable in this post-conflict setting with a high RR-TB prevalence. An expanded Xpert scale-up; the prompt initiation of shorter, safer, highly effective MDR-TB regimens; and treatment adherence support are critically needed to optimize outcomes.
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