Academic literature on the topic 'Multidrug resistant tuberculosis (MDR-TB)'
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Journal articles on the topic "Multidrug resistant tuberculosis (MDR-TB)"
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Caminero, Jose, and Charles Daley. "Management of Multidrug-Resistant Tuberculosis." Seminars in Respiratory and Critical Care Medicine 39, no. 03 (June 2018): 310–24. http://dx.doi.org/10.1055/s-0038-1661383.
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AbstractDrug-resistant strains of Mycobacterium tuberculosis pose a major threat to global tuberculosis control. Despite the availability of curative antituberculosis therapy for nearly half a century, inappropriate and inadequate treatment of tuberculosis, as well as unchecked transmission of M. tuberculosis, has resulted in alarming levels of drug-resistant tuberculosis. The World Health Organization (WHO) estimates that there were 600,000 cases of multidrug-resistant tuberculosis (MDR-TB)/rifampin-resistant (RR) tuberculosis in 2016, defined as strains that are resistant to at least isoniazid and rifampicin. Globally, WHO estimates that 4.1% of new tuberculosis cases and 19% of retreatment cases have MDR-TB. By the end of 2016, 123 countries had reported at least one case of extensively drug-resistant strains, which are MDR-TB strains that have acquired additional resistance to fluoroquinolones and at least one second-line injectable. It is estimated that only 22% of all MDR-TB cases are currently receiving therapy. This article reviews the management of MDR/RR-TB and updates recommendations regarding the use of shorter course regimens and new drugs.
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Mashidayanti, Aulia, Nurlely Nurlely, and Nani Kartinah. "Faktor Risiko Yang Berpengaruh Pada Kejadian Tuberkulosis dengan Multidrug-Resistant Tuberculosis (MDR-TB) di RSUD Ulin Banjarmasin." Jurnal Pharmascience 7, no. 2 (October 31, 2020): 139. http://dx.doi.org/10.20527/jps.v7i2.7928.
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MDR-TB (Multidrug-Resistant Tuberculosis) adalah salah satu jenis TB yang resisten dengan OAT (Obat Anti Tuberculosis) dengan resisten terhadap 2 obat anti tuberculosis yang paling ampuh yaitu rifampisin dan isoniazid. Obat rifampisin dan isoniazid sudah tidak efektif dalam membunuh kuman mycobacterium tuberkulosis dikarenakan kuman yang sudah resisten terhadap obat tersebut. MDR-TB merupakan suatu permasalahan yang menjadi hambatan utama dunia dalam pemberantasan TB. Tujuan dari penelitian ini adalah untuk mengidentifikasi faktor risiko apa saja yang dapat berpengaruh pada kejadian tuberkulosis dengan multidrug-resistant tuberculosis (MDR-TB) di RSUD Ulin Banjarmasin dengan variabel yang ditinjau adalah pengetahuan, motivasi dan keteraturan minum obat. Metode penelitian dengaan rancangan Cross Sectional dengan metode pengambilan dengan kuesioner. Populasi dalam penelitian ini adalah seluruh pasien dengan diagnosis tuberkulosis multidrug resistant tuberculosis (MDR-TB) dan pasien TB Non MDR yang digunakan sebagai pembanding yang dipilih secara acak. Hasil pada penelitian ini menunjukkan bahwa faktor risiko yang terbukti berpengaruh pada kejadian TB-MDR adalah keteraturan minum obat (p-value< 0,05). Oleh karena itu, untuk mengurangi potensi bertambahnya penderita TB-MDR, maka perlu diperhatikan lagi keteraturan minum obat penderita, memastikan agar penderita benar-benar rutin dan teratur dalam minum obat. MDR-TB (Multidrug-Resistant Tuberculosis) is one of tuberculosis characterized by resistant to anti-TB drug (Anti Tuberculosis Drug). An MDR-TB event is a resistance event to 2 of the most effective anti-TB drugs which are rifampicin and isoniazid. Rifampicin and isoniazid are no longer effective in killing Mycobacterium tuberculosis bacteria due to its resistant to the drug. The purpose of this study is to identify any risk factors that can affect the incidence of tuberculosis with multidrug-resistant tuberculosis (MDR-TB) in RSUD Ulin Banjarmasin. The variables in this study were knowledge, motivation and regularity of taking drugs. The research method was a cross sectional design using questionnaire to the patients. The population in this study was all patients with a diagnosis of multidrug resistant tuberculosis (MDR-TB) and non-MDR TB patients who used as a comparison which were selected randomly. The results of this study indicate that the risk factor that has been shown to influence the incidence of MDR-TB was the regularity of taking medication (p-value <0.05). Therefore, to reduce the potential of MDR-TB sufferers to increase, it is necessary to pay attention to taking drug regularity of patient, ensuring that the patient is really routine and taking medication regularly.Keywords: RSUD Ulin Banjarmasin, MDR-TB (Multidrug-Resistant Tuberculosis), Tuberculosis
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Paudel, Sita. "Risk Factors of Multidrug-Resistant Tuberculosis." International Journal of Applied Sciences and Biotechnology 5, no. 4 (December 24, 2017): 548–54. http://dx.doi.org/10.3126/ijasbt.v5i4.18771.
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Multidrug-resistant tuberculosis has been increased worldwide which is a severe problem. A case-control study was carried out among 50 MDR-TB cases and 63 drug susceptible controls to identify risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Lumbini Zone. Irregularity in taking medicine (OR=2.36), large family size (OR=2.40), farming as occupation (OR=2.83), history of TB and bovine at home (OR=6.5) were statistically associated with MDR-TB. Most of the MDR-TB cases were males (82%) and individual with the age group 21-30 years (40%) were highly infected with MDR-TBInt. J. Appl. Sci. Biotechnol. Vol 5(4): 548-554
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Yulianti, Yulianti, and Sally Mahdiani. "Gangguan pendengaran penderita Tuberkulosis Multidrug Resistant." Oto Rhino Laryngologica Indonesiana 45, no. 2 (December 31, 2015): 83. http://dx.doi.org/10.32637/orli.v45i2.112.
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Latar belakang: Tuberkulosis Multidrug Resistant (TB MDR) merupakan penyakit tuberkulosis (TB) yang resisten terhadap isoniazid dan rifampisin, dengan atau tanpa resisten terhadap obat anti- TB lain. Terapi aminoglikosida pada TB MDR berisiko untuk terjadinya gangguan fungsi telinga dan sistem keseimbangan tubuh, yang dapat bersifat irreversible atau permanen. Kerusakan pada koklea dapat menimbulkan penurunan pendengaran permanen. Tujuan: Mengetahui gangguan pendengaran penderita TB MDR di poliklinik TB MDR Ilmu Penyakit Dalam RS Hasan Sadikin Bandung. Metode: Penelitian deskriptif secara retrospektif pada pasien TB MDR yang berobat jalan di poliklinik TB MDR Ilmu Penyakit Dalam Rumah Sakit Hasan Sadikin Bandung periode 1 Januari - 31 Desember 2013. Hasil: Didapatkan gangguan pendengaran sebanyak 20,8% dari pasien TB MDR selama mendapat terapi TB MDR dengan keluhan tinitus dan gangguan pendengaran dengan onset timbulnya keluhan di bulan ke-3 (53,3%), kemudian bulan ke-6 (40%), dan bulan ke-10 (6,7%) setelah mulai pemberian terapi TB MDR. Pada pemeriksaan audiometri nada murni ditemukan penurunan pendengaran sensorineural yang bervariasi dari derajat ringan sampai berat. Kesimpulan: Pengobatan TB MDR dapat menyebabkan penurunan pendengaran sensorineural.Kata Kunci : Tuberkulosis Multidrug Resistant, audiometri nada murni, gangguan pendengaran sensorineural ABSTRACT Background: Multidrug Resistant Tuberculosis (MDR TB) is a tuberculosis (TB) which resistant to isoniazid and rifampin, with or without resistancy to other anti-TB drugs. Aminoglycoside therapy in MDR TB patients takes risks to malfunctioning of the ear and balance system. The hearing loss and balance system impairment that appeared are irreversible/permanent. Cochlear damage can cause permanent hearing loss. Purpose: To describe hearing loss in patients with MDR TB at MDR TB clinic of internal medicine in Hasan Sadikin hospital. Methods: A retrospective descriptive study on MDR TB patients in MDR TB outpatient clinic of Internal Medicine in Hasan Sadikin hospital in the period of January 1st to December 31th, 2013. Results: There were 20,8% of MDR TB patients who received treatment for MDR TB with tinnitus and hearing loss with onset of presentation at the 3rd month (53,3%), at the 6th month (40%), and at the 10th month (6,7%) of MDR TB therapy. Pure tone audiometry examination found sensorineural hearing loss with various degrees from mild to severe. Conclusion: Treatment of MDR TB could cause sensorineural hearing loss.Keywords: Tuberculosis Multidrug Resistant, pure tone audiometric, sensorineural hearing loss
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Khurram, Muhammad, Hamama Tul Bushra Khaar, and Muhammad Fahim. "Multidrug-resistant tuberculosis in Rawalpindi, Pakistan." Journal of Infection in Developing Countries 6, no. 01 (September 26, 2011): 29–32. http://dx.doi.org/10.3855/jidc.1738.
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Introduction: Multidrug-resistant (MDR) tuberculosis (TB) strains are resistant to isoniazid and rifampicin. Clinical characteristics, drug susceptibility patterns, and outcomes of MDR-TB patients treated at Holy Family Hospital, Rawalpindi, Pakistan, were studied from January 2007 to April 2010. Methodology: Thirty diagnosed patients (60% male and 40% female) of MDR pulmonary TB were included. Each patient was treated according to WHO guidelines and followed for two years. Clinical characteristics (age, gender, literate or illiterate educational status, employment status, and income), drug susceptibility testing (DST) reports, and outcome (cured, treatment failure, default, and died) of each patient was noted.Results: Mean patient age was 36.2 ± 15.4 years. In total, 60% patients were illiterate, 60% employed, 60% had income < Rs 5000 (42 Euro per month), 73.3% lived in an overcrowded residence, 60% were smokers, and 83.3% had taken anti-tuberculosis therapy previously. DST of MDR-TB strains for ethambutol, pyrazinamide, and streptomycin showed high resistance ( > 60%). Except for ofloxacin and ciprofloxacin, < 20% resistance was noted in second-line anti-tuberculosis agents. Overall, 10% of patients were cured, 40% died, 20% had treatment failure, and 30% patients defaulted.Conclusion: Pulmonary MDR-TB in Rawalpindi, Pakistan, is common in young males, poverty related circumstances, and has poor outcome. DST shows high resistance to first- line anti-tuberculosis agents and quinolones
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Huang, Huai, Yu-Shuai Han, Jing Chen, Li-Ying Shi, Li-Liang Wei, Ting-Ting Jiang, Wen-Jing Yi, Yi Yu, Zhi-Bin Li, and Ji-Cheng Li. "The novel potential biomarkers for multidrug-resistance tuberculosis using UPLC-Q-TOF-MS." Experimental Biology and Medicine 245, no. 6 (February 11, 2020): 501–11. http://dx.doi.org/10.1177/1535370220903464.
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The lack of rapid and efficient diagnostics impedes largely the epidemic control of multidrug-resistant tuberculosis, and might misguide the therapeutic strategies as well. This study aimed to identify novel multidrug-resistant tuberculosis biomarkers to improve the early intervention, symptomatic treatment and control of the prevalence of multidrug-resistant tuberculosis. The serum small molecule metabolites in healthy controls, patients with drug-susceptible tuberculosis, and patients with multidrug-resistant tuberculosis were screened using ultra-high-performance liquid chromatography combined with quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS). The differentially abundant metabolites were filtered out through multidimensional statistical analysis and bioinformatics analysis. Compared with drug-susceptible tuberculosis patients and healthy controls, the levels of 13 metabolites in multidrug-resistant tuberculosis patients altered. Among them, the most significant changes were found in N1-Methyl-2-pyridone-5-carboxamide (N1M2P5C), 1-Myristoyl-sn-glycerol-3-phosphocholine (MG3P), Caprylic acid (CA), and D-Xylulose (DX). And a multidrug-resistant tuberculosis/drug-susceptible tuberculosis differential diagnostic model was built based on these four metabolites, achieved the accuracy, sensitivity, and specificity of 0.928, 86.7%, and 86.7%, respectively. The enrichment analysis of metabolic pathways showed that the phospholipid remodeling of cell membranes was active in multidrug-resistant tuberculosis patients. In addition, in patients with tuberculosis, the metabolites of dipalmitoyl phosphatidylcholine (DPPC), a major component of pulmonary surfactant, were down-regulated. N1M2P5C, MG3P, CA, and DX may have the potential to serve as novel multidrug-resistant tuberculosis biomarkers. This research provides a preliminary experimental basis to further investigate potential multidrug-resistant tuberculosis biomarkers. Impact statement The MDR-TB incidence remains high, making the effective control of TB epidemic yet challenging. Rapid and accurate diagnosis is vitally important for improving the therapeutic efficacy and controlling the prevalence of drug resistance TB. Metabolomics has dramatic potential to distinguish MDR-TB and DS-TB. N1M2P5C, MG3P, CA, and DX that we identified in this study might have potential as novel MDR-TB biomarkers. The phospholipid remodeling of cell membranes was highly active in MDR-TB. The DPPC metabolites in TB were significantly down-regulated. This work aimed to investigate potential MDR-TB biomarkers to enhance the clinical diagnostic efficacy. The metabolic pathway distinctly altered in MDR-TB might provide novel targets to develop new anti-TB drugs.
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Gobaud, A. N., C. A. Haley, J. W. Wilson, R. Bhavaraju, A. Lardizabal, B. J. Seaworth, and N. D. Goswami. "Multidrug-resistant tuberculosis care in the United States." International Journal of Tuberculosis and Lung Disease 24, no. 4 (April 1, 2020): 409–13. http://dx.doi.org/10.5588/ijtld.19.0515.
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BACKGROUND: To examine the utilization of the Tuberculosis (TB) Centers of Excellence (COE) medical consultation service and evaluate how these services were being employed for patients in relation to multidrug-resistant TB (MDR-TB).METHODS: Medical consults are documented in a secure database. The database was queried for MDR-TB consultations over the period 1 January 2013–31 December 2017. All were analyzed to assess provider type, center, setting, year of call, and type of patient (pediatric vs. adult). A subgroup was randomly selected for thematic analysis.RESULTS: The centers received 1560 MDR-TB consultation requests over this period. Providers requesting consults were primarily physicians (55%). The majority of requests were from public health departments (64%) and for adult patients (80%). Four major topic areas emerged: 1) initial management of MDR-TB, 2) MDR-TB longitudinal treatment and complications, 3) management of persons exposed to MDR-TB, and 4) MDR-TB treatment completion.CONCLUSIONS: Analysis of these consultations provides insight into the type of expert advice about MDR-TB that was provided. These findings highlight topics where increased medical training and education may help to improve MDR-TB-related practices.
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Butov, D., C. Lange, J. Heyckendorf, I. Kalmykova, T. Butova, N. Borovok, M. Novokhatskaya, and D. Chesov. "Multidrug-resistant tuberculosis in the Kharkiv Region, Ukraine." International Journal of Tuberculosis and Lung Disease 24, no. 5 (May 1, 2020): 485–91. http://dx.doi.org/10.5588/ijtld.19.0508.
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OBJECTIVE: To document the level of drug resistance in MDR-TB patients and to characterize management capacities for their medical care and MDR-TB treatment outcomes in the Kharkiv region of Ukraine. This area has one of the highest frequencies of MDR-TB worldwide.METHODS: A retrospective observational cohort study was performed on registry data from the regional anti-TB dispensary in Kharkiv. All microbiologically confirmed MDR-TB patients registered in 2014 were included. Diagnostic, treatment and post-treatment follow-up data were analysed.RESULTS: Of 169 patients with MDR-TB, 55.0% had pre-extensively drug-resistant (pre-XDR) or XDR resistant patterns. Rapid molecular diagnosis by GeneXpert and liquid M. tuberculosis cultures were only available for 66.9% and 56.8% of patients, respectively. Phenotypic drug-susceptibility testing (DST) for high priority TB drugs (bedaquiline, linezolid, clofazimine) were not available. DST for later generation fluroquinolones was available only in 53.2% of patients. 50.9% of patients had less than 4 drugs in the treatment regimen proven to be effective by DST. More than 23.1% of patients with MDR-TB failed their treatment and only 45.0% achieved a cure.CONCLUSION: The high prevalence of MDR-TB and poor MDR-TB treatment outcomes in the Kharkiv region, is associated with substantial shortages in rapid molecular and phenotypic DST, a lack of high priority MDR-TB drugs, poor treatment monitoring and follow-up capacities.
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Samper, S., M. J. Iglesias, and O. Tello. "The Spanish multidrug resistant tuberculosis network." Eurosurveillance 5, no. 4 (April 1, 2000): 43–45. http://dx.doi.org/10.2807/esm.05.04.00037-en.
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The network to monitor the spread of multidrug resistance tuberculosis (MDR-TB) in Spain based on genomic typing and set up in January 1998 benefits from the participation of about 90% of the laboratories of the national health system. Of the 94 MDR-TB pa
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Datta, Bikram Singh, Ghulam Hassan, Syed Manzoor Kadri, Waseem Qureshi, Mustadiq Ahmad Kamili, Hardeep Singh, Ahmad Manzoor, Mushtaq Ahmad Wani, Shamas u. Din, and Natasha Thakur. "Multidrug-Resistant and Extensively Drug Resistant Tuberculosis in Kashmir, India." Journal of Infection in Developing Countries 4, no. 01 (November 21, 2009): 019–23. http://dx.doi.org/10.3855/jidc.669.
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Background: To study the profile of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in tertiary care hospital setting, representing almost the whole affected population in Kashmir valley of India. Methodology: A total of 910 cases of pulmonary tuberculosis were enrolled over four years. Among these, cases of MDR-TB and XDR-TB were meticulously studied for drug susceptibility, treatment, adverse effects profile and overall survival. Results: Fifty-two (5.7%) cases of MDR-TB were identified, among which eight (15.3%) were diagnosed as XDR-TB on the basis of drug susceptibility testing, using the prescribed definition. The cases were sensitive to 2, 3, 4, 5 and more than 5 drugs in almost equal proportions. Thirty-seven (71.1%) cases were successfully cured; eleven (21.1%) patients died; and only four (7.6%) cases defaulted, indicating overall satisfactory adherence to treatment. Conclusion: For effective treatment of MDR-TB and XDR-TB, early case detection, improved laboratory facilities, availability of appropriate treatment regimens, and financial assistance in resource-limited settings through effective political intervention are necessary for better patient adherence and overall cure.
Dissertations / Theses on the topic "Multidrug resistant tuberculosis (MDR-TB)"
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Adebanjo, Omotayo David. "Knowledge, attittudes and practices of healthcare workers about prevention and control of multidrug-resistant tuberculosis at Botsabelo Hospital Maseru, Lesotho." Thesis, University of Limpopo ( Medunsa Campus), 2011. http://hdl.handle.net/10386/423.
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Thesis (MPH)--University of Limpopo, 2011.Background: Tuberculosis is one of the major public health problems in Lesotho. With the occurrence of multi-drug resistant tuberculosis, little is known about the views of health care workers on this disease. The aim of this study was to investigate the knowledge, attitudes, and practices of healthcare professionals about prevention and control of MDR-TB at Botsabelo hospital, situated in Maseru, Lesotho. Methods: This study was conducted by means of a semi-structured, anonymous, and self-administered questionnaire that was sent to health care workers. Returned questionnaires were collected through designated boxes stationed at selected places at the study site from 23rd September to 13th October 2010. The investigator and his assistants collected the returned questionnaires on the 15th October 2010. Results: The results of this study indicate that, overall, less than half (47.3%) of respondents had good level of knowledge about MDR-TB; but the overwhelming majority of them held negative attitude towards patients with MDR-TB. Further analysis showed that the level of knowledge did not affect the attitude towards patients suffering from MDR-TB but it influenced their practices. Having good level of knowledge about MDR-TB was associated with good practices such as the use of protective masks and MDR-TB guidelines and involvement in educating patients about MDR-TB. Moreover, the findings of this study showed also that the attitude of respondents towards patients suffering from MDR-TB did not influence their practices. Conclusion: In conclusion, less than half of respondents had good level of knowledge about MDR-TB, but over 85.5% of them held negative attitude towards patients suffering from MDR-TB. Although the level of knowledge about MDR-TB was found not to have influenced the attitude of respondents towards patients suffering from MDR-TB; and that xi their attitude did not influence practices, good level of knowledge was positively associated with safer practices such as using protective masks, educating patients on MDR-TB, and referring to the MDR-TB guidelines manual. An educational remedial intervention is recommended.
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Akçakir, Yasemin. "Correlates of treatment outcomes of multidrug-resistant tuberculosis (MDR-TB): a systematic review and meta-analysis." Thesis, McGill University, 2010. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=86914.
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Background: Multi-drug resistant tuberculosis (MDR-TB) is a major threat to global tuberculosis control. While observational studies have reported outcomes of MDR-TB treatment, there have been no randomized controlled trials for MDR-TB treatment outcomes. We did a systematic review and meta-analysis to examine individual and study-level factors associated with treatment outcomes for MDR-TB in the observational studies.Method: We searched MEDLINE, EMBASE, BIOSIS, Web of Science from 1970 to July 2008, for publications in any language that described at least one treatment outcome among at least 25 patients with microbiologically proven MDR-TB. Data were extracted and where missing, principle investigators were contacted for more information. Rates of treatment outcomes were pooled using random effects. Subgroup analyses and meta-regression models were used to explore sources of heterogeneity.
Results: After screening 2187 titles and abstracts, 265 articles were identified for retrieval and full-text review, and of these, 72 articles met the inclusion criteria and were included in the meta-analysis. Data analysis was performed using the 64 unique cohorts reported by the 72 articles. The cohorts were quite heterogeneous in characteristics and outcomes. The mean size of the cohorts was 124 patients (range 25 to 1011). The mean age of participants in the cohorts was 39 years with females accounting for about one third. The median length of treatment was 18 months, and the average number of drugs in the regimen was five. The overall pooled rates of cumulative success (successful patients who did not relapse) was 50%, of cumulative failure (failure plus relapse) was 17%, of death was 13% and of default was 18%. These pooled outcome rates, however, must be interpreted with caution because of heterogeneity across studies. Subgroup and meta-regression analyses helped identify several factors associated with improved outcomes. Factors significantly associated with increased treatment success are treatment duration longer than 20 months, use of more than three sensitive drugs, individualized regimen, use of fluoroquinolones, or use of second-line agents in general. Factors that were significantly associated with high treatment mortality were high prevalence of HIV co-infection and use of three or fewer drugs. Low default rate was most strongly associated with shorter treatments and directly observed therapy. Use of second-line drugs was significantly associated with higher default rate. Considerable heterogeneity remained even within subgroups.
Conclusion: Outcomes of MDR-TB appear to vary considerably across studies and populations. The heterogeneity among studies poses a challenge in interpreting the results of this meta-analysis for clinical care, underscoring the need for future research to clarify optimal treatment of MDR-TB.
Contexte : La tuberculose multi-résistante (TB-MR) est une menace importante pour le contrôle de la tuberculose dans le monde. Tandis que les études d'observation ont rapporté des résultats de traitements de TB-MR, il n'y a eu aucune étude randomisée. Nous avons fait une revue systématique de la littérature et une méta-analyse afin d'examiner les facteurs liés aux résultats de traitement pour TB-MR, au niveau de l'individu et de l'étude, dans les études d'observation.
Méthode : Nous avons cherché à l'aide de MEDLINE, EMBASE, BIOS, et Web of Science, les publications dans toutes les langues qui décrivent au moins un résultat de traitement parmi au moins 25 patients atteints de TB-MR microbiologiquement prouvée, de 1970 à juillet 2008. Les données ont été extraites et les taux de résultats de traitement ont été mis en commun en utilisant le modèle d'effet au hasard random effect. Des analyses de sous-groupes et des modèles de méta régression ont été employés pour explorer les sources d'hétérogénéité.
Résultats : Après avoir répertorié2187 titres et résumés d'articles, 265 articles ont été identifiés et sélectionnées afin de récupérer le texte intégral pour les réviser; 72 de ces articles ont répondu aux critères d'inclusion et ont été inclus dans la méta analyse. L'analyse de données a été exécutée en utilisant les 64 cohortes uniques rapportées par les 72 articles. Les cohortes étaient hétérogènes dans leurs caractéristiques et leurs résultats. La taille moyenne des cohortes était de 124 patients (25 à 1011). L'âge moyen des participants était de 39 ans et les femmes représentaient environ le tiers des participants. La longueur médiane du traitement était de 18 mois et les patients recevaient en moyenne cinq médicaments différents. Le taux global de succès cumulatif (patients guéris qui n'ont pas fait de rechute) était de 50%, d'échec cumulatif (échec plus rechute), 17%, de mort, 13% et d'abandon de traitement, 18%. Toutefois, ces taux doivent être interprétés avec prudence en raison de l'hétérogénéité à travers des études. Avec des analyses de sous-groupes et de méta régression plusieurs facteurs associées à succès de traitement ont été identifier, comme - durée de traitement plus que 20 mois, utilisation de 3 médicaments ou plus, traitement individualise, ou l'utilisation de médicaments de secondes lignes. Facteurs associe avec la mortalité étaient haut prévalence de VIH et utilisation de 3 médicaments ou moins. Un taux élevé de non-adherence etait associe avec traitement plus longue, auto administration de médicaments, et l'utilisation de médicaments de seconde ligne. Une importante hétérogénéité est demeurée même dans les sous-groupes.
Conclusion : Les résultats de TB-MR semblent varier considérablement selon les études et les populations. L'hétérogénéité parmi les études pose un défi dans l'interprétation des résultats de cette méta analyse, soulignant le besoin d'autre recherche afin d'évaluer le traitement optimal pour TB-MR.
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Smith, Louise. "Resilience of the partners of long term hospitalised patients with multidrug-resistant (MDR) and extreme drug-resistant (XDR) tuberculosis (TB)." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1020913.
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Patients diagnosed with Multidrug-resistant(MDR) and Extreme drug-resistant (XDR) tuberculosis (TB) have to be hospitalised for a period of six to twelve months, according to the MDR/XDR Policy Guidelines on the treatment of drug-resistant TB – until the patient recovers, and is no longer infectious. There are factors associated with both the patients’ and their partners’ (spouses) resistance to long-term hospitalisation. This has resulted in several acts of violence against the hospital property and members of the health-care team. However, there are a small number of partners who assist the health-care team – by ensuring compliance from the patients and providing their continued support to the patient – despite their own risk of being infected with MDR and XDR TB. This qualitative study was aimed at exploring and describing the resilience factors that have been observed amongst a small number of partners of patients with MDR and XDR TB at an in-patient treatment centre in Port Elizabeth. The research design was exploratory, descriptive and contextual in nature; and the researcher interviewed eight spouses or live-in partners of patientsfor this study, until data saturation was achieved. The data were collected through semi-structured interviews; and the data analysis was conducted, according to the eight steps proposed by Tesch model of data analysis (in Creswell, 1998).Guba’smodel of trustworthiness was used to assess the data collected during the interviews. The findings from this study will inform the health-care team on methods of how the support of the patients’ partners could be mobilised in the holistic treatment plan of MDR and XDR TB patients in an in-patient treatment centre.
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Souza, Márcia Alves de. "Avaliação do desempenho da PCR Multiplex alelo específico para detecção de genes de Mycobacterium tuberculosis associados à resistência a Rifampicina e Isoniazida, a partir de amostra clínica." Universidade Federal do Amazonas, 2013. http://tede.ufam.edu.br/handle/tede/2565.
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A Tuberculose (TB) é uma doença infecciosa causada pelo complexo Mycobacterium tuberculosis, sendo considerada um grave problema de saúde pública mundial. Atualmente, isolados de M. tuberculosis resistentes a pelo menos um medicamento utilizado no tratamento da TB tem sido documentados em todos os países. De acordo com a Organização Mundial de Saúde (OMS) a TB multirresistente (TBMR) é definida quando, isolados de M. tuberculosis de pacientes apresentam resistência a pelo menos Isoniazida e Rifampicina, os dois fármacos fundamentais no tratamento da TB. A resistência à Rifampicina tem sido associada às mutações gênicas no bacilo, no gene rpoB (referentes aos códons 531, 526 e 516). Para a Isoniazida, as mutações associadas à resistência têm sido relatadas nos genes katG, inhA, ahpC e kasA, sendo que a mutação no gene katG, referente ao códon 315, tem sido a mais citada para resistência a este fármaco. Neste contexto, métodos moleculares têm sido propostos pra detecção de mutações gênicas, em isolados de M. tuberculosis, que possam estar associadas à resistência aos fármacos. O presente estudo avaliou o desempenho da PCR multiplex alelo específico (PCR-MAS), diretamente em 86 amostras de escarro de pacientes com TB pulmonar multibacilares (n=42) e paucibacilares (n=44) da Policlínica Cardoso Fonte. A PCR-MAS teve como alvos: os genes katG ,inhA e rpoB. A concordância entre a PCR-MAS e o Método de Redução de Nitrato foi avaliada utilizando o teste kappa e a associação entre as mutações gênicas e a resistência fenotípica aos fármacos foi realizada pelo teste exato de Fisher. A análise de concordância, pelo teste kappa, foi realizada entre as PCR-MAS a partir de amostra de escarro e de isolados de M. tuberculosis. A PCR-MAS apresentou fraca concordância com o Método de Redução de Nitrato, pois de 18 amostras resistentes à Isoniazida, apenas em 4 (22,2%) foram detectadas as mutações para o gene katG ou inhA. No entanto, a avaliação da sensibilidade fenotípica à Rifampicina, apresentou boa concordância com a PCR-MAS (kappa = 0,7237), quando as amostras foram de pacientes de TB pulmonar multibacilar. Além disso, houve associação da presença de mutações no gene rpoB com resistência fenotípica à Rifampicina (p = 0.0014). Em relação a concordância entre as PCR-MAS, de amostras de escarro e seus respectivos isolados de M. tuberculosis, o desempenho foi excelente quando testados em amostras de pacientes com TB pulmonar multibacilar, para detecção de mutações no gene rpoB (kappa = 0,7742). Portanto, os resultados obtidos com a PCR-MAS, a partir de amostras de escarros, foram satisfatórios e poderão ser utilizados para monitorar e pesquisar as mutações associada à resistência à Rifampicina em pacientes de TB multibacilar na rede básica de saúde, pois é um teste rápido, reprodutível e de menor custo.
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Tinzi, Siphokuhle. "Exploration of experiences of patients with the adverse-drug effects of multidrug-resistant tuberculosis treatment in a primary health care facility in the Western Cape." University of the Western Cape, 2017. http://hdl.handle.net/11394/5660.
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Magister Curationis - MCurMultidrug resistant TB (MDR-TB) is a form of TB caused by bacteria (germs) that are resistant to the usual drugs that are used to treat "normal" TB. The duration of treatment for MDR-TB is a maximum of 22 months. People with MDR-TB are treated in specialized tertiary hospitals and in out-patient clinics in the PHC facilities. The treatment includes a six months injectable phase with a wide range of TB drugs. The adverse effects of MDR-TB drugs are among the worst side effects ever reported by patients. The aim of the current study was to explore the experiences of adverse effects of MDR-TB treatment amongst patients in a primary health care facility in the Western Cape. An explorative qualitative study design was used to explore the experiences of patient with the adverse effects of MDR-TB treatment in a primary health care facility in the Western Cape. In depth interviews were conducted with 12 MDR-TB patients. Data analysis was done by using the Tesch's method of content analysis. The study revealed that participating MDR-TB patients experienced various emotional, financial, physical and social challenges. Participants explained that the experience of being on MDR-TB treatment is emotionally draining; the pain and discomfort of the adverse effect of treatment makes a person to feel anxious and depressed. Financially they depended on social grants because they had to stop working after starting treatment. They could not function well physically because of the toxic nature of the adverse effects of treatment; which resulted in fatigue, dizziness and burning sensation on the feet and hands. They were faced with a lot of stigma from the community and even family members because of their illness. The study also revealed that in spite of the challenges and obstacles the participants were all motivated to complete their treatment and get cured. It is recommended that more support structures be made available for patients who are being treated for MDRT-TB such as; psychotherapy, social support and counselling on health education. Provision needs to be made for patients who are receiving daily injection; for it to be given in their homes. Health care providers treating MDR-TB patients need to do home visits together with MDR-TB adherence counsellors, to monitor the physical wellbeing of patients at home. This will also provide patients with the platform to discuss their health concerns in a more accommodative and relaxed environment. New drug regimen with fewer tablets and less treatment duration is needed for MDR-TB.
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Vallie, Razia. "Assessing and comparing the effectiveness of treatment for multidrug resistant tuberculosis between specialized TB hospital in-patient and general outpatient clinic settings within the Western Cape Province, South Africa." University of the Western Cape, 2016. http://hdl.handle.net/11394/5600.
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Magister Public Health - MPHBackground: Multidrug resistant tuberculosis (MDR TB) is a growing threat globally. The large increase in the incidence and prevalence of MDR TB in South Africa in recent years has impacted on the way in which MDR TB is managed within the health services. It became logistically difficult to manage MDR TB by treating all patients as in-patients in a specialized tuberculosis (TB) hospital. The clinics, which are run by nurses and/or general medical officers, are then required to manage this more complex form of TB, with limited resources, less experience and assumingly with less MDR TB knowledge. Of particular concern is that shifting of the patient management from specialized TB hospitals to Primary Health Care clinics which might worsen the already poor MDR TB treatment outcomes. There has been minimal assessment of the management of MDR TB at clinic level and hence the comparison of treatment outcomes for those patients initiated on treatment in clinics compared to in-patients in specialized TB hospitals is urgently needed. Aim: To compare the treatment outcomes and the effectiveness of medication regimens provided to MDR TB patients initiated on treatment in specialized TB hospitals as inpatients, to that of MDR TB patients initiated on treatment as outpatients at community clinics within the Western Cape Province, South Africa. Methodology Study Design: A retrospective cohort study was undertaken, as the length of treatment for a MDR TB patient can be for 24 months or longer and this study was based on treatment outcome data. Study Population and sample: The study population was uncomplicated MDR TB patients initiated on treatment in hospitals and clinics from January 2010 to December 2012. The sample comprised of 568 participants that were laboratory confirmed to have MDR TB and had the outcomes of their treatment recorded in an electronic database or a paper register. Data Collection: The researcher collected MDR TB information from standardized MDR TB registers as well as an electronic MDR TB database. Analysis: Data was analyzed comparing the exposed (clinic initiated) and unexposed (hospital initiated) cohorts incidence of 4 key treatment outcomes, namely: successfully treated, failed treatment, died and defaulted treatment. Bivariate analysis (relative and absolute) was done to determine the cumulative incidence ratio and cumulative incidence difference and multivariate logistic regression analysis for the adjusted odds ratio to control for confounders and effect modifiers. Ethics: Permission to conduct this research was obtained from the relevant authorities. The confidentiality of the participants as per the Department of Health policy and in adherence to general ethical guidelines was strictly maintained. The study proposal received ethical clearance and approval from the University of the Western Cape Research Committee. Results: All participants within this study received the appropriate treatment as per the MDR TB guidelines. The incidence rate for the main outcomes of this study indicated that successfully treated for the clinic initiated participants was 41% and 31% for the hospital initiated participants. ‘Defaulted’ treatment was 39% and 41%, ‘failed’ treatment 7% and 13% and ‘died’ was 14% and 16%, respectively. The clinic initiated participants appeared to have better treatment outcomes on bivariate analysis, however on multivariate analysis, there was no difference in the treatment outcomes of the clinic initiated participants compared to the hospital initiated participants, and therefore the clinic initiated treatment is seen as effective. The time to treatment initiation for clinic and hospital initiated participants is excessively long for both cohorts, with a median of 29 days, and 37 days respectively. The key findings of note in the multivariate analysis is that the Human Immunodeficiency Virus positive (HIV+) participants provided with antiretrovirals therapy (ART) were, based on adjusted cumulative incidence ratios, 6.6 times more likely to have a successfully treated outcome (95% CI 1.48-29.84), and were 0.2 times less likely to die (95% CI 0.08-0.53). Having a previous cured history of TB and no previous history of TB were 2.9 times more likely to have a successfully treated outcome (95% CI 1.48-5.56) and were 0.1 times (0.04-0.38) less likely to fail treatment. An interesting finding was that participants living in the rural districts were 2.6 times more likely to die. Conclusion: Clinic initiated treatment for uncomplicated MDR TB is as effective as hospital initiated treatment. Also, those provided with ART and those without previous TB or who had a previous bout of TB cured, had better outcomes. Main Recommendations: The Western Cape health department should continue with the decentralization of MDR TB services to the clinics and could safely consider expanding the decentralization to include uncomplicated Preextensively drug-resistant TB and Extensively drug-resistant TB patients. Offering ART to HIV+ patients should be mandatory. The delays in the time to treatment initiation of MDR TB need to be further investigated.
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Azores, Molovon Jr Pasagui. "Possible Risk Factors for Multidrug-Resistant Tuberculosis Infection in the Philippines." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3551.
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Multidrug-resistant Mycobacterium tuberculosis (MDR-TB) is a leading cause of morbidity and mortality in the Philippines. The purpose of this study was to gain knowledge about the relationship between potential risk factors and MDR-TB. Risk factors (the independent variables) for MDR-TB (the dependent variable) include previous TB treatment, infection with HIV, exposure to patients with drug-susceptible TB/MDR-TB, delays in diagnosis and treatment, employment status, smoking, imprisonment, alcohol abuse, and poor compliance with TB treatment regimens. The study was based on the epidemiological approach to causal inference work. A case-control study design was used wherein a quantitative method was applied in data analysis to assess the strength of the pre-identified possible risk factor(s) association to MDR-TB infection. Data were collected using survey questionnaires that were administered to patients (N = 172) from health centers in Leyte, San Mateo Rizal, and San Lazaro. Hypotheses were tested using chi-square analysis, Fisher's exact test, and an odd ratio. Drug-susceptible TB respondents who smoked on a daily basis were three times more likely (95% CI 1.021-13.341, OR 3.69) to develop an MDR-TB infection than were other respondents. Respondents who did not comply with the anti-TB treatment regimen were nine times more likely (95% CI 2.104-43.059, OR 9.519) to develop an MDR-TB infection than other respondents. Health care providers may be able to use study findings to develop programs to help drug-susceptible TB patients stop smoking and better comply with treatment regimens designed to prevent MDR-TB infection, resulting, potentially, in improved public health outcomes for patients.
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Visser, Hanri. "Mechanisms of resistance to new generation anti-TB drugs." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96863.
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Thesis (MScMedSc)--Stellenbosch University, 2015.ENGLISH ABSTRACT: Drug resistance in Mycobacterium tuberculosis is an increasing global problem. Drug resistance is mostly caused by single nucleotide polymorphisms (SNPs) within the bacterial genome. This observed increase in global incidence of drug resistant tuberculosis (TB) has sparked the search for new anti-TB drugs and the repurposing of drugs that are currently used against other organisms or species of mycobacteria. One such repurposed drug, clofazimine (CFZ), is currently used for the treatment of leprosy, caused by Mycobacterium leprae. The mechanism of action of CFZ is not clear, but it is hypothesized that CFZ is reduced by a mycobacterial type II NADH oxidoreductase (NDH-2). The reduction of CFZ drives the production of reactive oxygen species (ROS) which is toxic to the pathogen. The aim of this study was to elucidate the mechanism of CFZ resistance. Towards this aim, spontaneous in vitro CFZ resistant mutants were selected, characterized and whole genome was used identify SNPs which may cause CFZ resistance. Mutations were identified in a transcriptional regulator encoded by Rv0678, fatty-acid-AMP ligase, or FadD28 (Rv2941) and glycerol kinase or GlpK (Rv3696c). Mutations in Rv0678 have previously been shown to play a role in both CFZ resistance and bedaquiline (BDQ) cross-resistance, while no link has been found between CFZ resistance and mutations in fadD28 and glpK. The novel, non-synonymous SNP identified in Rv0678 resulted in the replacement of an alanine residue with threonine at codon 84, which is located in the DNA binding domain. Virtual modelling of the mutated Rv0678 protein showed that the A84T mutation may influence DNA binding, possibly due to its proximity to the DNA binding domain. This mutation caused a change in hydrophobicity, which may influence binding to DNA. Previous studies showed that mutations in Rv0678 resulted in the upregulation of mmpL5, a putative efflux pump. However, the mechanism whereby CFZ resistance occurs via increased abundance of this efflux pump in the cell wall is not clear and needs further investigation. The cross-resistance between CFZ and BDQ, caused by mutations in Rv0678, is of concern and may influence the planning of anti-TB drug regimens for the future. The roles of the other two mutations identified in this study in CFZ resistance is also not clear and requires further investigation. Finally, the findings of this study support the role of Rv0678 in CFZ resistance thereby suggesting that this gene could be useful as a diagnostic marker to test for CFZ resistance in clinical isolates.
AFRIKAANSE OPSOMMING: Middelweerstandigheid in Mycobacterium tuberculosis is 'n wêreldwye toenemende probleem. Middelweerstandigheid word meestal veroorsaak deur enkel nukleotied polimorfismes (SNPs) in die bakteriële genoom. Hierdie toename in middelweerstandige tuberkulose (TB) het gelei tot die soektog na nuwe anti-TB-middels en die alternatiewe aanwending van middels wat tans teen ander organismes of spesies van mikobakterieë gebruik word. Een so 'n alternatiewe middel, clofazimine (CFZ), word tans gebruik vir die behandeling van melaatsheid wat veroorsaak word deur Mycobacterium leprae. CFZ se meganisme van werking is nie duidelik nie, maar dit word vermoed dat CFZ gereduseer word deur 'n mikobakteriële tipe II NADH oksidoreduktase (NDH-2). Die reduksie van CFZ dryf die produksie van reaktiewe suurstof spesies wat giftig is vir die patogeen. Die doel van hierdie studie was om die meganisme van CFZ weerstandigheid te ondersoek. Om hierdie doel te bereik was spontane in vitro CFZ weerstandige mutante gekies, gekarakteriseer en heel genoom volgorde bepaling is gebruik om SNPs te identifiseer wat CFZ weerstandigheid veroorsaak. Mutasies in Rv0678, 'n transkripsie reguleerder, vetsuur-AMP ligase, of FadD28 (Rv2941) en gliserol kinase of GlpK (Rv3696c) geïdentifiseer. Dit is al voorheen gevind dat mutasies in Rv0678 ‘n rol speel in beide CFZ weerstandigheid en bedaquiline (BDQ) kruis-weerstandigheid, terwyl geen verband gevind is tussen CFZ weerstandigheid en mutasies in fadD28 en glpK nie. Die nuwe, nie-sinonieme SNP, geïdentifiseer in Rv0678 het gelei to die vervanging van 'n alanien aminosuur met treonien by kodon 84, wat geleë is in die DNS bindings domein. Virtuele modellering van die gemuteerde Rv0678 proteïen het getoon dat die A84T mutasie DNS binding moontlik kan beïnvloed, as gevolg van sy nabyheid aan die DNS bindings domein. Hierdie mutasie veroorsaak 'n verandering in die hidrofobiese natuur, wat DNS binding kan beïnvloed. Vorige studies het getoon dat mutasies in Rv0678 lei tot die opregulering van mmpL5, 'n waarskynlike uitvloei pomp. Die meganisme waardeur CFZ weerstandigheid veroorsaak, deur ‘n groot aantal van hierdie uitvloei pompe in die selwand, is nie duidelik nie en moet verder ondersoek word. Die kruis-weerstandigheid tussen CFZ en BDQ, wat veroorsaak word deur mutasies in Rv0678, is van belang en kan die beplanning van anti-TB middel behandeling vir die toekoms beïnvloed. Die rolle van die ander twee mutasies, wat in hierdie studie geïdentifiseer is, in CFZ weerstandigheid is ook nie duidelik nie en vereis verdere ondersoek. Ten slotte, die bevindinge van hierdie studie steun die rol van Rv0678 in CFZ weerstandigheid en dit dui daarop dat hierdie geen gebruik kan word as 'n diagnostiese merker om vir CFZ weerstandigheid te toets in kliniese isolate.
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Franco, Marília Masello Junqueira. "Genotipagem e pesquisa de resistência fenotípica e genética à rifampicina e isoniazida em linhagens de Mycobacterium bovis isoladas de linfonodos de bovinos de abatedouro na região centro-oeste do estado de São Paulo." Botucatu, 2016. http://hdl.handle.net/11449/143102.
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Orientador: Antonio Carlos PaesResumo: A tuberculose causada por Mycobacterium bovis (bTB) é uma zoonose de distribuição mundial com ampla gama de hospedeiros. Nos países onde a bTB é prevalente, 10 a 20% dos casos de tuberculose humana são causados por M. bovis. São escassos em todo o mundo estudos que investigam a resistência à isoniazida (INH) e rifampicina (RMP) em linhagens de M. bovis de origem bovina, reservatórios silvestres, e em casos humanos de tuberculose. Foi investigada a diversidade genotípica de 67 linhagens de M. bovis isoladas de bovinos de abatedouro, obtidas de 100 linfonodos com lesão caseosa, pelas técnicas de Spoligotyping e MIRU-VNTR, bem como foi determinado o perfil fenotípico de resistência à INH e RMP pela técnica de REMA, e pesquisadas possíveis bases genéticas para resistência aos antimicrobianos. Dentre os isolados, 11 (16%) foram classificados como MDR-TB, 8 (12%) resistentes à INH e 2 (3%) resistentes à RMP. A pesquisa pelo GenoType MTBDRplus ver. 2.0 não acusou a presença de mutações em nenhum dos isolados fenotipicamente resistentes. Foram identificados 16 spoligotipos entre as linhagens. A subfamília BOV_1 predominou com 52 (77,6%) isolados, com os SIT 481, 482, 594, 665, 691, 698, 1021, 1667, 1852, 2141 e dois isolados sem shared type. A BOV_2 foi identificada em 8 (11,9%) isolados, com o SIT 683. Os SIT 982, 1851 e 1853 foram agrupados na família BOV. Dois isolados não foram classificados em família ou subfamília. A análise de MIRU-VNTR com painel de 12 MIRUs, identificou 31 i... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Tuberculosis caused by Mycobacterium bovis (bTB) is a zoonosis of worldwide distribution with broad host range. In countries where bTB is prevalent, 10-20% of the human cases of tuberculosis are caused by M. bovis. All over the world there are few studies investigating the resistance to isoniazid (INH) and rifampicin (RMP) in M. bovis strains from cattle, wild reservoirs, and human cases of tuberculosis. The genotypic diversity of 67 M. bovis strains obtained out of 100 lymph nodes with caseous lesions from slaughtered animals was investigated by Spoligotyping and MIRU-VNTR techniques, as well as the assessment of their phenotypic profile of resistance to INH and RMP by REMA method and the search of possible genetic basis for antimicrobial resistance. Among the obtained isolates, 11 (16%) were classified as MDR-TB, 8 (12%) INH-resistant and 2 (3%) RMP-resistant. The use of GenoType MTBDRplus ver. 2.0 did not pointed the presence of genetic mutations in any of the phenotypically resistant isolates. Sixteen different spoligotype patterns were identified. The BOV_1 subfamily predominated with 52 (77.6%) isolates, with SITs 481, 482, 594, 665, 691, 698, 1021, 1667, 1852, 2141 and two isolates without a given SIT. BOV_2 was identified in 8 (11.9%) isolates, within SIT 683. The SITs 982, 1851 and 1853 were grouped in BOV family. Two isolates were not classified in family or subfamily. The MIRU-VNTR analysis using the 12 classical MIRUs, identified a cluster of 31 isolates belonging... (Complete abstract click electronic access below)
Doutor
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Pule, Caroline. "Defining the role of efflux pump inhibitors on anti-TB drugs in Rifampicin resistant clinical Mycobacterium Tuberculosis isolates." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86758.
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Thesis (MScMedSc)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Central dogma suggests that mutations in target genes is the primary cause of resistance to first and second-line anti-TB drugs in Mycobacterium tuberculosis. However, it was previously reported that approximately 5% of Rifampicin mono-resistant clinical M. tuberculosis did not harbor mutations in the rpoB gene. The present study hypothesized that active efflux plays a contributory role in the level of intrinsic resistance to different anti-TB drugs (Isoniazid, Ethionamide, Pyrazinamide, Ethambutol, Ofloxacin, Moxifloxacin, Ciprofloxacin, Streptomycin, Amikacin and Capreomycin in RIF mono-resistant clinical M. tuberculosis isolates with a rpoB531 (Ser-Leu) mutation. This study aimed to define the role of Efflux pump inhibitors (verapamil, carbonylcyanide m-chlorophenylhydrazone and reserpine) in enhancing the susceptibility to different anti-TB drugs in the RIF mono-resistant clinical isolates. The isolates were characterized by determining the level of intrinsic resistance to structurally related/unrelated anti-TB drugs; determining the effect of EPIs on the level of intrinsic resistance in the isolates and comparing the synergistic properties of the combination of EPIs and anti-TB drugs. To achieve this, genetic characterization was done by PCR and DNA sequencing. Phenotyping was done by the MGIT 960 system EpiCenter software to determine the MICs of the different anti-TB drugs and the effect of verapamil and carbonylcyanide m-chlorophenylhydrazone on determined MICs. Due to inability to test reserpine in a MGIT, a different technique (broth microdilution) was used for the reserpine experiment. Additionally; fractional inhibitory concentrations (FIC) indices were calculated for each of these drugs. The FIC assess the anti-TB drugs/inhibitor interactions. STATISTICA Software: version 11 was used for statistical analysis. Results revealed that the RIF mono-resistant isolates were sensitive at the critical concentrations of all 10 drugs tested, with the exception of Pyrazinamide. This could be explained by the technical challenges of phenotypic Pyrazinamide testing. A significant growth inhibitory effect was observed between the combination of EPI and anti-TB drug exposure in vitro. This suggests that verapamil, carbonylcyanide m-chlorophenylhydrazone and reserpine play a significant role in restoring the susceptibility (decrease in intrinsic resistance level) of the RIF mono-resistant isolates to all anti-TB drugs under investigation. Additionally, a synergistic effect was observed by the combination treatment of the anti-TB drugs with the different EPIs. Based on these findings, we proposed a model suggesting that efflux pumps are activated by the presence of anti-TB drugs. The activated pumps extrude multiple or specific anti-TB drugs out of the cell, this in turn decrease the intracellular drug concentration, thereby causing resistance to various anti-TB drugs. In contrast, the addition of EPIs inhibits efflux pump activity, leading to an increase in the intracellular drug concentration and ultimate cell death. This is the first study to investigate the effect of different efflux pumps inhibitors on the level of intrinsic resistance to a broad spectrum of anti-TB drugs in drug resistant M. tuberculosis clinical isolates from different genetic backgrounds. The findings are of clinical significance as the combination of treatment with EPI and anti-TB drugs or use of EPIs as adjunctives could improve MDR-TB therapy outcome.
AFRIKAANSE OPSOMMING: Sentrale dogma beweer dat mutasies in teiken gene die primêre oorsaak van die weerstandheid teen anti-TB-middels in Mycobacterium tuberculosis is. Vorige studies het getoon dat ongeveer 5% van Rifampisien enkelweerstandige kliniese M. tuberculosis isolate nie ‘n mutasie in die rpoB geen het nie. Die hipotese van die huidige studie was dat aktiewe pompe 'n bydraende rol speel in die vlak van intrinsieke weerstandheid teen 10 verskillende anti-TB-middels (Isoniasied, Ethionamied, Pyrazinamied, Ethambutol, Ofloxacin, Moxifloxacin, Siprofloksasien, Streptomisien, Amikasien and Capreomycin) in RIF enkelweerstandige kliniese M . tuberculosis isolate met 'n rpoB531 (Ser-Leu) mutasie. Die doel van hierdie studie was om die rol van uitpomp inhibeerders (verapamil, carbonylcyanide m-chlorophenylhydrazone en reserpien) te definieer in die verbetering van die werking vir verskillende anti-TB-middels in die RIF enkelweerstandige kliniese isolate. Die doelstellings van die studie was om die vlak van intrinsieke weerstandigheid teen struktureel verwante/onverwante anti-tuberkulose middels asook die effek van die EPIs op die vlak van intrinsieke weerstand in die isolate is bepaal. Verder is sinergistiese eienskappe van die kombinasie van EPIs en anti-TB-middels ondersoek. Hierdie doelstellings is bereik deur genetiese karakterisering deur PKR en DNS volgorde bepaling. Fenotipering is gedoen deur gebruik te maak van MGIT 960 EpiCenter sagteware om die Minimum Inhibisie Konsentrasie (MIC) van die verskillende anti-TB-middels en die effek van verapamil en carbonylcyanide m-chlorophenylhydrazone op die MIC te bepaal. Reserpien kan nie in die MGIT sisteem getoets word nie, and daarom is 'n ander tegniek (mikro-verdunning) is gebruik om die effek van reserpien te toets. Fraksionele inhiberende konsentrasies (FIC) is bereken vir elk van hierdie middels die anti-TB-middels / inhibeerder interaksies te bepaal. STATISTICA v11 sagteware is gebruik vir alle statistiese analises. Resultate van hierdie studie toon dat die RIF enkelweerstandige isolate sensitief is teen kritieke konsentrasies van al die middels, met die uitsondering van Pyrazinamied. Weerstandigheid van Pyrazinamied kan wees as gevolg van welbekende tegniese probleme met die standaard fenotipiese pyrazinamied toets. ‘n Beduidende groei inhiberende effek is waargeneem tussen die kombinasie van EPI en anti-TB middel blootstelling in vitro. Dit dui daarop dat verapamil, CCCP en reserpine 'n belangrike rol speel in die herstel van die sensitiwiteit (afname in intrinsieke weerstand vlak) van die RIF enkelweerstandige isolate aan alle anti-TB-middels wat ondersoek is. Daarbenewens is 'n sinergistiese effek waargeneem deur die kombinasie van die verskillende anti-TB-middels en die verskillende EPIs. Op grond van hierdie bevindinge het ons ‘n model voorgestel wat toon dat uitvloei pompe geaktiveer word deur die teenwoordigheid van anti-TB-middels en die geaktiveerde pompe dan verskeie of spesifieke anti-TB-middels uit die sel pomp. Dus verminder die intrasellulêre konsentrasie van die middel en veroorsaak daardeur weerstandigheid teen verskeie anti-TB-middels. Die byvoeging van EPIs inhibeer uitvloei pompe se werking en lei tot 'n toename in die intrasellulêre konsentrasie van die middels en uiteindelik die dood van die selle. Hierdie is die eerste studie wat die effek van verskillende uitvloei pompe inhibeerders op die vlak van intrinsieke weerstand teen 'n breë spektrum van anti-TB-middels in die middel-weerstandige kliniese isolate ondersoek. Die bevindinge kan van belangrike kliniese belang wees aangesien die kombinasie van behandeling met EPI en anti-TB-middels die uitkoms MDR-TB terapie kan verbeter.
Books on the topic "Multidrug resistant tuberculosis (MDR-TB)"
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Vinšová, Jarmila. Development of new MDR-tuberculosis drugs. Hauppauge, N.Y: Nova Science Publisher, 2010.
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World Health Organization (WHO). Management of MDR-TB: A field guide, a companion document to Guidelines for the programmatic management of drug-resistant tuberculosis. Geneva: World Health Organization, 2009.
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3
Wiegandt, Axel. Framework to address multi-drug-resistant TB in the Pacific island countries and territories. Noumea, New Caledonia: Secretariat of the Pacific community, 2010.
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author, Wilker Ian, and Ambrose Marylou author, eds. Tuberculosis and superbugs: Examining TB and bacterial infections. Berkeley Heights, NJ: Jasmine Health, 2014.
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5
Border, Peter. Diseases fighting back: The growing resistance of TB and other bacterial diseases to treatment. London: Parliamentary Office of Science and Technology, 1994.
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The global threat of drug-resistant TB: A call to action for World TB Day : briefing and hearing before the Subcommittee on Africa and Global Health of the Committee on Foreign Affairs, House of Representatives, One Hundred Tenth Congress, first session, March 21, 2007. Washington: U.S. G.P.O., 2007.
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Rocío, Valverde Aliaga, and Partners in Health (Organization). Sucursal Perú., eds. Venciendo la TB-MDR: 20 testimonios de expacientes con tuberculosis multidrogo resistente. Lima, Perú: Socios en Salud Sucursal Perú, 2006.
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Wilker, Ian, and Evelyn B. Kelly. Tuberculosis and Superbugs: Examining TB and Bacterial Infections. Enslow Publishing, LLC, 2014.
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Stefan H. E. Kaufmann (Editor) and H. Hahn (Editor), eds. Mycobacteria and Tb (Issues in Infectious Diseases, 2). S. Karger Publishers (USA), 2002.
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Hadiarto, Mangunnegoro. Present Situation of Multidrug-Resistant Tuberculosis & the Possibility of Mdr-Tb Treatment by New Quinolones: Proceedings of a Satellite Symposium for ... of the Chest, Bali, June 1996 (Chemotherapy). S Karger Pub, 1996.
Find full textBook chapters on the topic "Multidrug resistant tuberculosis (MDR-TB)"
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Bensard, Denis D., Philip F. Stahel, Jorge Cerdá, Babak Sarani, Sajid Shahul, Daniel Talmor, Peter M. Hammer, et al. "Multidrug-Resistant Tuberculosis (MDR TB)." In Encyclopedia of Intensive Care Medicine, 1429. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-00418-6_3209.
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McAuslane, Helen, and Dominik Zenner. "Multidrug-Resistant Tuberculosis (MDR-TB)." In Case Studies in Infection Control, 133–46. London; New York : Taylor & Francis Group, [2018]: Garland Science, 2018. http://dx.doi.org/10.1201/9780203733318-12.
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Silesky-Jiménez, Juan Ignacio. "Tuberculosis Multidrug Resistance (MDR-TB)." In Highly Infectious Diseases in Critical Care, 235–52. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-33803-9_14.
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Nguyen, Binh, Greg J. Fox, Paul H. Mason, and Justin T. Denholm. "Preventive Therapy for Multidrug Resistant Latent Tuberculosis Infection: An Ethical Imperative with Ethical Barriers to Implementation?" In Ethics and Drug Resistance: Collective Responsibility for Global Public Health, 19–35. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-27874-8_2.
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Abstract Multidrug resistant tuberculosis (MDR-TB) has a substantial impact on individuals and communities globally, including lengthy, expensive and burdensome therapy with high rates of treatment failure and death. Strategies to prevent disease are well established for those who acquire latent tuberculosis infection (LTBI) after exposure to drug susceptible TB (DS-TB). However, there has been limited research or programmatic experience regarding the prevention of MDR-TB. Accordingly, while global recommendations strongly emphasize the need to deliver LTBI therapy after TB exposure, most programs do not do so where MDR LTBI is identified. The paucity of prospective randomized trial evidence for the effectiveness of MDR LTBI therapy, and concerns regarding its adverse effects, have been used to justify a reluctance to scale up programmatic interventions to prevent MDR-TB, or to participate in research evaluating such strategies. However, such a response fails to adequately balance potential risks of therapy with the substantial harms associated with inaction. Furthermore, the cost of inaction falls disproportionately on the most vulnerable members of society, including children. Delays in implementing proven preventive strategies may also mask hidden programmatic concerns, particularly regarding the financial cost and other burdens of treating drug resistant infection. Reticence to engage with preventative therapy for MDR-TB, even in the absence of high-level evidence, may run counter to the best interests of individuals who have been exposed to MDR-TB. This chapter will explore ethical tensions raised by expanding access to preventative therapies for MDR-TB, and consider how ethically optimal responses to this adverse condition may be evaluated. An ethical perspective on evidentiary burden will be addressed, emphasizing how MDR LTBI research may both offer, and be shaped by, paradigmatic insights into human research ethics more generally. Emerging research and illustrations from the authors programmatic engagement in Vietnam are offered as case examples, because social and community expectations and norms may challenge, or support, implementation of therapy for drug-resistant infection. Such circumstances prompt consideration of the broader questions of social impact, such as the potential for widespread preventive therapy to accelerate the development of antimicrobial resistance.
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Shawa, Remmy, Fons Coomans, Helen Cox, and Leslie London. "Access to Effective Diagnosis and Treatment for Drug-Resistant Tuberculosis: Deepening the Human Rights-Based Approach." In Ethics and Drug Resistance: Collective Responsibility for Global Public Health, 155–69. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-27874-8_10.
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Abstract The lack of access to effective diagnosis and treatment for drug-resistant tuberculosis (DR-TB) remains a persistent ethical, human rights and public health challenge globally. In addressing this challenge, arguments based on a Human Rights-Based Approach (HRBA) to health have most often been focused on the Right to Health. However, a key challenge in multidrug-resistant (MDR-) and extensively drug-resistant (XDR-) TB is the glaring absence of scientific research; ranging from basic science and drug discovery through to implementation science once new tools have been developed. Although the Right to Enjoy the Benefits of Scientific Progress and its Applications (REBSP) is a little theorised human right, it has the potential to enrich our understanding and use of the Rights-Based Approach to health. In this chapter, we argue that States’ duties to respect, protect and fulfil the REBSP within and outside their borders is an important vehicle that can be drawn on to redress the lack of research into new drug development and appropriate use of existing drugs for DR-TB in high burden settings. We call for urgent attention to minimum core obligations for the REBSP and the need for a General Comment by a UN human rights monitoring body to provide for its interpretation. We also note that conceptualization of the REBSP has the potential to complement Right to Health claims intended to enhance access to treatment for DR-TB on a global scale.
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Upadhyay, Tarun K., Akanksha Sharma, Nida Fatima, Amit Singh, Pavan Muttil, and Rolee Sharma. "Targeted Delivery of Antibiotics Using Microparticles to Combat Multidrug-Resistant Tuberculosis." In Antibacterial Drug Discovery to Combat MDR, 441–57. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-13-9871-1_20.
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Singh, Amit, Anil Kumar Gupta, and Sarman Singh. "Molecular Mechanisms of Drug Resistance in Mycobacterium tuberculosis: Role of Nanoparticles Against Multi-drug-Resistant Tuberculosis (MDR-TB)." In NanoBioMedicine, 285–314. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-32-9898-9_12.
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Prasad, Rajendra. "Multidrug-Resistant Tuberculosis (MDR-TB)." In Practical Approach to Respiratory Diseases, 387. Jaypee Brothers Medical Publishers (P) Ltd., 2005. http://dx.doi.org/10.5005/jp/books/10638_51.
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Chapman, Stephen J., Grace V. Robinson, Rahul Shrimanker, Chris D. Turnbull, and John M. Wrightson. "Respiratory infection—mycobacterial." In Oxford Handbook of Respiratory Medicine, edited by Stephen J. Chapman, Grace V. Robinson, Rahul Shrimanker, Chris D. Turnbull, and John M. Wrightson, 585–622. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198837114.003.0043.
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Includes: Tuberculosis: epidemiology and pathophysiology, first-line anti-TB drugs, TB chemotherapy with comorbid disease, multidrug-resistant TB (MDR-TB), latent TB infection, TB and anti-TNF-α treatment, disseminated BCG infection (BCGosis), future developments in TB, non-tuberculous mycobacteria (NTM), NTM species and lung disease.
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Prasad, Rajendra, and Nikhil Gupta. "Multidrug Resistant Tuberculosis (MDR-TB): Current Scenario." In Manual of Tuberculosis, 147. Jaypee Brothers Medical Publishers (P) Ltd., 2015. http://dx.doi.org/10.5005/jp/books/12435_19.
Full textConference papers on the topic "Multidrug resistant tuberculosis (MDR-TB)"
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Kurnianingsih, Widya, Didik Gunawan Tamtomo, and Bhisma Murti. "Incomplete Medication Intake and Multidrug Resistant Tuberculosis." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.01.58.
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Background: Multidrug Resistant Tuberculosis (MDR-TB) is a highest problem in the prevention and eradication of TB worldwide. MDR-TB exists in 27 countries where there are at least 6,800 MDR-TB cases annually and 12% of new TB cases registered are MDR TB. This study aimed to examine the effect of incomplete medication intake on the incidence of MDR TB. Subjects and Method: Meta-analysis and systematic review was conducted by collecting articles from Google Scholar, Pubmed, and Springer Link databases, from year 2010 to 2019. Keywords used “Risk Factor MDR TB” OR “Previous Treatment” AND “Multidrug resistant tuberculosis”. The inclusion criteria were full text, using English language, using case control study design, and reporting adjusted odds ratio. The study population was patients with Tuberculosis. The intervention was incomplete medication intake with comparison complete medication intake. The study outcome was multidrug resistant Tuberculosis. Collected articles were selected by PRISMA flow chart. Quantitative data were analyzed by fixed effect model using Revman 5.3. Results: 6 studies from Taiwan, Bangladesh, Malaysia, and Ethiophia were selected for data analysis. This study reported that incomplete medication intake increased the risk of multidrug resistant tuberculosis (aOR= 14.33; 95% CI= 12.47 to 16.47; p<0.001). Conclusion: Incomplete medication intake increases the risk of multidrug resistant Tuberculosis. Keywords: incomplete medication intake, multidrug resistant tuberculosis Correspondence: Widya Kurnianingsih. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: widyakurnianingsih08@gmail.com. Mobile: 081556837033
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Falzon, Dennis, Ernesto Jaramillo, and Karin Weyer. "Multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) : global response." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.oa1944.
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Babalık, Aylin, Ayse Rumeysa Hazine, Gul Erdal Donmez, Olga Akkan, Fatma Kutluhan, Ahmet Balıkcı, Gulay Catmabacak, Kaya Koksalan, and Tülin Kuyucu. "Evaluation of 123 Cases with MDR TB (Multidrug Resistant Tuberculosis) Treatment." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa4745.
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Karaman, Onur, Yelda Varol, Can Bicmen, Tülay Akarca, Sevket Dereli, and Didem Ozbakır. "Treatment Results of Multidrug Resistant Tuberculosis (MDR-TB) Patients in the Aegean Region." In ERS International Congress 2021 abstracts. European Respiratory Society, 2021. http://dx.doi.org/10.1183/13993003.congress-2021.pa3348.
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Shinta, Mega, Sabaniah Indjar Gama, and Adam M. Ramadhan. "KAJIAN PENGOBATAN DAN KEPATUHAN PASIEN MULTIDRUG-RESISTANT TUBERCULOSIS (MDR-TB) DI RSUD A.W SJAHRANIE SAMARINDA." In the 4th Mulawarman Pharmaceuticals Conferences. Fakultas Farmasi, Universitas Mulawarman, Samarinda, 2016. http://dx.doi.org/10.25026/mpc.v4i1.182.
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Zaman, F., and M. Asaduzzaman. "Priority identification in the clinical case management of multidrug resistant Tuberculosis (MDR-TB) in Bangladesh." In ERS International Congress 2022 abstracts. European Respiratory Society, 2022. http://dx.doi.org/10.1183/13993003.congress-2022.1122.
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Singhal, Pratibha, Vivek Toshniwal, Swapnil Kulkarni, and Kapil Iyer. "Study of drug resistance profile in Multidrug resistant tuberculosis (MDR TB) patients attending a tertiary care hospital at Mumbai." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa2704.
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Gualano, Gina, Rocco Urso, Rosati Silvia, Tonnarini Roberto, Biagioli Daniele, Matteucci Giuseppe, Ghirga Piero, et al. "Treatment outcomes among multidrug-resistant tuberculosis (MDR-TB) cases at a referral hospital of infectious diseases in Italy." In ERS International Congress 2016 abstracts. European Respiratory Society, 2016. http://dx.doi.org/10.1183/13993003.congress-2016.pa2688.
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Rajendran, Mahindran. "Prevalence of Multidrug Resistant Tuberculosis among TB Patients in Malaysia." In ERS International Congress 2021 abstracts. European Respiratory Society, 2021. http://dx.doi.org/10.1183/13993003.congress-2021.pa1726.
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Muliati, Ida Leida Maria, and Muh Syafar. "Treatment Response Analysis in Patients with Multidrug Resistant Tuberculosis (MDR TB) at Labuang Baji Public Hospital in Makassar City." In the 2nd International Conference. New York, New York, USA: ACM Press, 2018. http://dx.doi.org/10.1145/3239438.3239495.
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