Treatment outcomes for patients with multidrug-resistant tuberculosis in post-earthquake Port-au-Prince, Haiti

Am J Trop Med Hyg. 2014 Oct;91(4):715-21. doi: 10.4269/ajtmh.14-0161. Epub 2014 Jul 28.

Abstract

We report outcomes and 12-month survival for the first cohort of patients to undergo multidrug-resistant tuberculosis (MDR-TB) treatment after the earthquake in Haiti. From March 3, 2010 to March 28, 2013, 110 patients initiated treatment of laboratory-confirmed MDR-TB at the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Center in Port-au-Prince, Haiti. Twenty-seven patients (25%) were human immunodeficiency virus (HIV)-positive. As of October 31, 2013, 95 (86%) patients were either cured or alive on treatment, 4 (4%) patients defaulted, and 11 (10%) patients died. Culture conversion occurred by 30 days in 14 (13%) patients, 60 days in 49 (45%) patients, and 90 days in 81 (74%) patients. The probabilities of survival to 12 months were 96% (95% confidence interval [95% CI] = 89-99) and 85% (95% CI = 64-94) for HIV-negative and -positive patients, respectively. Despite adverse conditions, outcomes for patients with MDR-TB are highly encouraging. Major efforts are underway to scale up community directly observed therapy and expand care to other regions of Haiti.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • Antitubercular Agents / adverse effects
  • Antitubercular Agents / therapeutic use*
  • Cohort Studies
  • Directly Observed Therapy
  • Disasters
  • Earthquakes
  • Female
  • Follow-Up Studies
  • HIV Seronegativity*
  • HIV Seropositivity / complications*
  • HIV Seropositivity / drug therapy
  • Haiti
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Sputum / microbiology
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / diagnosis
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Young Adult

Substances

  • Anti-HIV Agents
  • Antitubercular Agents