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771. Drug Resistance Tuberculosis (DR-TB), Comorbidities and Risk Factors Identified in a Prospective Multicenter Cohort Study in Indonesia

BACKGROUND: The numbers of patients with drug resistance TB (DR-TB) increased annually by over 20% globally in the last decade. However, data on the prevalence of DR-TB in Indonesia are limited. The objective of this study to estimate the proportion of DR-TB in new and previously treated TB cases, a...

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Detalles Bibliográficos
Autores principales: Burhan, Erlina, Wibisono, Banteng, Indah, Retna, Sajinadiyasa, Gede Ketut, Riyanto, Bambang, Kusmiati, Tutik, Susanto, Nugroho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254384/
http://dx.doi.org/10.1093/ofid/ofy210.778
Descripción
Sumario:BACKGROUND: The numbers of patients with drug resistance TB (DR-TB) increased annually by over 20% globally in the last decade. However, data on the prevalence of DR-TB in Indonesia are limited. The objective of this study to estimate the proportion of DR-TB in new and previously treated TB cases, and to identify comorbidities and risk factors. METHODS: This study has been conducted at seven hospitals throughout Indonesia since March 2017. Clinically TB patients ≥18-year-old were enrolled and followed until 6 months after treatment completed. Demography and clinical data were recorded; sputum, blood, urine, and PBMC were collected at several time points. AFB smear, sputum culture, Xpert MTB/RIF, and drug sensitivity tests were performed. Drug resistance TB is determined by Xpert MTB/RIF. RESULTS: Of 151 enrolled patients, 103 (68%) were confirmed M. tuberculosis by Xpert MTB/RIF, and 47 (46%) were confirmed rifampicin resistance. The distribution of DR-TB in each study site is shown in Figure 1. Among those with comorbidities (38%), comorbidity with diabetes (based on HbA1c level and diabetes history), HIV, and cancer was 9%, 26%, and 7%. Demography, nutrition status, contact and treatment history, and comorbidities are shown in Table 1. DR-TB primary infection contributes to 23% of DR-TB cases. Biomarkers that may predict treatment failure and TB-genotyping are underway. CONCLUSION: The proportion of DR-TB in both new and previously treated patients in our cohort was significantly higher than the estimated number from the WHO and Ministry of Health. TB is a serious threat for public health and mitigation plan must be implemented at all levels. [Image: see text] DISCLOSURES: All authors: No reported disclosures.