Effectiveness of the Standard WHO Recommended Retreatment Regimen (Category II) for Tuberculosis in Kampala, Uganda: A Prospective Cohort Study

2011

Effectiveness of WHO Recommended Retreatment Regimen for Tuberculosis in Uganda

Sample size: 288 publication 10 minutes Evidence: moderate

Author Information

Author(s): Jones-López Edward C., Ayakaka Irene, Levin Jonathan, Reilly Nancy, Mumbowa Francis, Dryden-Peterson Scott, Nyakoojo Grace, Fennelly Kevin, Temple Beth, Nakubulwa Susan, Joloba Moses L., Okwera Alphonse, Eisenach Kathleen D., McNerney Ruth, Elliott Alison M., Ellner Jerrold J., Smith Peter G., Mugerwa Roy D.

Primary Institution: Boston Medical Center, Boston University Medical School

Hypothesis

The effectiveness of the WHO-recommended standardized retreatment regimen for tuberculosis has not been systematically evaluated.

Conclusion

The standard retreatment regimen for tuberculosis in Uganda yields an unacceptable proportion of unsuccessful outcomes.

Supporting Evidence

20% of HIV-uninfected and 26% of HIV-infected patients had unsuccessful treatment outcomes.
Factors associated with unsuccessful outcomes included poor adherence, HIV infection, and age.
All patients with multidrug-resistant TB had unsuccessful treatment outcomes.
HIV-infected individuals were more likely to die than HIV-uninfected individuals.

Takeaway

This study looked at how well a common treatment for tuberculosis works in Uganda, and found that many patients do not get better.

Methodology

A prospective cohort study was conducted with smear-positive, pulmonary TB patients treated with the WHO-recommended regimen, followed for treatment outcomes and mortality.