Evidence map›Paper›PMID 32822375›Full record

ArticlePloS one2020

Translating drug resistant tuberculosis treatment guidelines to reality in war-torn Kandahar, Afghanistan: A retrospective cohort study.

Anita Mesic, Waliullah H Khan, Annick Lenglet, Lutgarde Lynen, Sadiqqulah Ishaq, Ei Hnin Hnin Phyu, Htay Thet Mar, Anthony Oraegbu, Mohammad Khaled Seddiq, Hashim Khan Amirzada and 5 more

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Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–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

7 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Tuberculosis care models for children and adolescents: a scoping review.Bulletin of the World Health Organization · 2022
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Anita MesicMédecins Sans Frontières, Amsterdam, The Netherlands.ORCID 0000-0002-7541-6380
Waliullah H KhanMédecins Sans Frontières, Islamic Republic of Afghanistan, Kabul, Afghanistan.
Annick LengletMédecins Sans Frontières, Amsterdam, The Netherlands.
Lutgarde LynenInstitute of Tropical Medicine Antwerp, Antwerp, Belgium.
Sadiqqulah IshaqMédecins Sans Frontières, Islamic Republic of Afghanistan, Kandahar, Afghanistan.
Ei Hnin Hnin PhyuMédecins Sans Frontières, Islamic Republic of Afghanistan, Kandahar, Afghanistan.
Htay Thet MarMédecins Sans Frontières, Islamic Republic of Afghanistan, Kandahar, Afghanistan.
Anthony OraegbuMédecins Sans Frontières, Islamic Republic of Afghanistan, Kandahar, Afghanistan.
Mohammad Khaled SeddiqNational Tuberculosis Control Programme, Islamic Republic of Afghanistan, Kabul, Afghanistan.
Hashim Khan AmirzadaNational Tuberculosis Control Programme, Islamic Republic of Afghanistan, Kabul, Afghanistan.
Jena FernhoutMédecins Sans Frontières, Amsterdam, The Netherlands.
Charity KamauMédecins Sans Frontières, Amsterdam, The Netherlands.
Cono AritiCentre for Trials Research, Cardiff University Medical School, Cardiff, United Kingdom.
Diana GomezMédecins Sans Frontières, Amsterdam, The Netherlands.
Tom DecrooInstitute of Tropical Medicine Antwerp, Antwerp, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAfghanistan is affected by one of the world's longest protracted armed conflicts, frequent natural disasters, disease outbreaks and large population movements and it suffers from a high burden of tuberculosis (TB), including rifampicin-resistant TB (RR-TB). The study shows Médecins Sans Frontières' experiences with care for patients with RR-TB in Kandahar Province. We describe the uptake of RR-TB treatment, how World Health Organisation criteria for the choice between the short and an individualized regimen were implemented, and treatment outcomes.

methodsThis is a retrospective cohort analysis of routinely collected data from RR-TB patients enrolled in care from 2016 until 2019. Descriptive analysis was performed to present characteristics of patients and treatment outcomes. Multivariable Cox analysis was performed to identify risk factors for having an unfavourable treatment outcome.

resultsOut of 146 enrolled RR-TB patients, 112 (76.7%) started treatment: 41 (36.6%) and 71 (63.4%) with the short and individualized treatment regimen, respectively. Of 82 with results for fluoroquinolone susceptibility, 39 (47.6%) had fluoroquinolone-resistant TB. Seven patients with initially fluoroquinolone-resistant TB and three pregnant women started the short regimen and 18 patients eligible for the short regimen started the injectable-free individualized regimen. Overall, six-month smear and culture conversion were 98.7% and 97.1%, respectively; treatment success was 70.1%. Known initial fluoroquinolone resistance (aHR 3.77, 95%CI:1.53-9.27) but not choice of regimen predicted having an unfavourable outcome.

conclusionEven though criteria for the choice of treatment regimen were not applied strictly, we have achieved acceptable outcomes in this cohort. To expand RR-TB care, treatment regimens should fit provision at primary health care level and take patient preferences into account.

Indexed as

AdolescentAdultAfghanistanAntitubercular AgentsFemaleFluoroquinolonesHumansMalePregnancyRetrospective StudiesRifampinTreatment OutcomeTuberculosis, Multidrug-ResistantWorld Health OrganizationYoung AdultAntitubercular AgentsFluoroquinolonesRifampin

Identifiers

PMID32822375
PMCPMC7446914

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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.