Evidence map›Paper›PMID 31073710›Full record

Observational studyInfection2019

Implementation of multidrug-resistant tuberculosis (MDR-TB) treatment in Gabon: lessons learnt from the field.

U Ateba-Ngoa, J R Edoa, B R Adegbite, E G Rossatanga, D Madiou, A Mfoumbi, C Mevyann, P Achimi Agbo, J Mahoumbou, S Gould and 7 more

Open access · hybridAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Infection, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
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

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
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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

17 authors at 3 institutions in 2 countries.

U Ateba-Ngoa *Centre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
J R Edoa *Centre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
B R Adegbite *Centre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
E G RossatangaCentre Hospitalier Régional Georges Rawiri de Lambaréné, Lambarene, Gabon.
D MadiouCentre Hospitalier Régional Georges Rawiri de Lambaréné, Lambarene, Gabon.
A MfoumbiCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
C MevyannCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
P Achimi AgboCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
J MahoumbouProgramme National de Lutte contre la Tuberculose, Ministry of Health, Libreville, Gabon.
S GouldCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
B LellCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
A A AdegnikaCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
C KöhlerCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
P G KremsnerCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
M Massinga-LoembeCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
A AlabiCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon.
M P GrobuschCentre des Recherches Médicales de Lambaréné, Lambarene, Gabon. m.p.grobusch@amsterdamumc.nl.
Centre de Recherche Médicales de Lambaréné · GAUniversity of Tübingen · DEMinistre de la Forêt,de la Mer et de l'Environnement · GA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSince May 2016, WHO recommended a 9-12 month short-treatment regimen for multidrug-resistant tuberculosis (MDR-TB) treatment known as the 'Bangladesh Regimen'. However, limited data exist on the appropriateness thereof, and its implementation in low- and middle-income countries (LMIC). We report here on the pilot phase of the evaluation of the Bangladesh regimen in Gabon, prior to its endorsement by the WHO.

methodsThis ongoing observational study started in September 2015. Intensive training of hospital health workers as well as community information and education were conducted. GeneXpert-confirmed MDR-TB patients received the second-line anti-tuberculosis drugs (4KmMfxPtoHCfzEZ/5MfxCfzEZ). Sputum smears and cultures were done monthly. Adverse events were monitored daily.

resultsEleven patients have been treated for MDR-TB piloting the short regimen. All were HIV-negative and presented in poor health with extensive pulmonary lesions. The overall sputum culture conversion rate was 64% after 4 months of treatment. Three patients developed marked hearing loss; one a transient cutaneous rash. Of 11 patients in our continuous care, 7 (63.6%) significantly improved clinically and bacteriologically. One (9.1%) patient experienced a treatment failure, two (18.2%) died, and one (9.1%) was lost to follow up.

conclusionsOur pioneering data on systematic MDR-TB treatment in Gabon, with currently almost total absence of resistance against the second-line drugs, demonstrate that a 9-month regimen has the capacity to facilitate early culture negativity and sustained clinical improvement. Close adverse events monitoring and continuous care are vital to success.

Indexed as

AdultAntitubercular AgentsBangladeshDrug Administration ScheduleFemaleGabonHumansMaleMiddle AgedPilot ProjectsSputumTreatment FailureTreatment OutcomeTuberculosis, Multidrug-ResistantTuberculosis, PulmonaryWorld Health OrganizationAntitubercular AgentsGabonMultidrug resistanceShort-course regimenTuberculosis

Identifiers

PMID31073710
OpenAlexW2944651037

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.