scholarly journals Person‐centred care and short oral treatment for rifampicin‐resistant tuberculosis improve retention in care in Kandahar, Afghanistan

2022 ◽  
Author(s):  
Anita Mesic ◽  
Sadiqullah Ishaq ◽  
Waliullah H. Khan ◽  
Atiqullah Mureed ◽  
Htay Thet Mar ◽  
...  
Keyword(s):  
Oral Treatment ◽  
Retention In Care ◽  
Resistant Tuberculosis

scholarly journals The anti-tubercular drug delamanid as a potential oral treatment for visceral leishmaniasis

eLife ◽  
2016 ◽  
Vol 5 ◽  
Author(s):  
Stephen Patterson ◽  
Susan Wyllie ◽  
Suzanne Norval ◽  
Laste Stojanovski ◽  
Frederick RC Simeons ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Dose Response ◽  
Leishmania Donovani ◽  
Oral Treatment ◽  
Cost Effective ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Effective Drugs

There is an urgent requirement for safe, oral and cost-effective drugs for the treatment of visceral leishmaniasis (VL). We report that delamanid (OPC-67683), an approved drug for multi-drug resistant tuberculosis, is a potent inhibitor of Leishmania donovani both in vitro and in vivo. Twice-daily oral dosing of delamanid at 30 mg kg-1 for 5 days resulted in sterile cures in a mouse model of VL. Treatment with lower doses revealed a U-shaped (hormetic) dose-response curve with greater parasite suppression at 1 mg kg-1 than at 3 mg kg-1 (5 or 10 day dosing). Dosing delamanid for 10 days confirmed the hormetic dose-response and improved the efficacy at all doses investigated. Mechanistic studies reveal that delamanid is rapidly metabolised by parasites via an enzyme, distinct from the nitroreductase that activates fexinidazole. Delamanid has the potential to be repurposed as a much-needed oral therapy for VL.

scholarly journals Factors contributing to drug-resistant tuberculosis treatment outcome in five countries in the Eastern Europe and Central Asia region

2020 ◽  
Vol 90 (1) ◽  
Author(s):  
Christian Auer ◽  
Rais Mazitov ◽  
Alisher Makhmudov ◽  
Bobojon Pirmahmadzoda ◽  
Alena Skrahina ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Eastern Europe ◽  
Central Asia ◽  
Oral Treatment ◽  
Primary Health Care System ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Clinical Records ◽  
Desk Review

Drug-resistant tuberculosis (DR-TB) is a global challenge and a major contributor of death from anti-microbial resistance. With the main aim to determine factors contributing to treatment outcomes observed among DR-TB patients in the countries in Eastern Europe and Central Asia (EECA), a multi-method study was conducted in: Azerbaijan, Belarus, Romania, Tajikistan and Ukraine. Both quantitative and qualitative methodologies were used for data collection and analysis. The quantitative approaches included a desk review of documents related to the DR-TB responses and an analysis of clinical records of DR-TB patients in selected health facilities of the five countries. Qualitative methods included in-depth interviews with national TB programme (NTP) managers, other healthcare providers and non-governmental organizations (NGOs) workers, as well as interviews and Focus Group Discussions (FGDs) with DR-TB patients. The desk review of 38 reports identified as the main challenges to address DR-TB financial and/or management issues and adverse events of the medicines. The most common recommendations related to treatment outcome focussed on general programme management, treatment regimen composition, clinical management and social support for the patients. In all the five countries the NTPs still have a vertical structure. Some integration into the primary health care system (PHC) already exists but further involvement of PHC facilities is feasible and recommended. Interviews with stakeholders indicated that alcoholism and homelessness and a lack of appropriate response to these issues remain as major challenges for a sub-set of patients. Civil society groups, NGOs and communities are substantially engaged in providing different services to DR-TB patients, especially in Ukraine, Romania and Tajikistan. Data from clinical records of 212 patients revealed that independent risk factors for unfavourable treatment outcome (death, loss to follow-up, failure) were culture-positivity at two months of treatment, history of treatment with second-line drugs and homelessness. More powerful, less toxic and shorter oral treatment regimens as well as comprehensive patient support are needed to improve treatment outcome of patients with DR-TB.

scholarly journals Interventions to improve retention-in-care and treatment adherence among patients with drug-resistant tuberculosis: a systematic review

2018 ◽  
Vol 53 (1) ◽  
pp. 1801030 ◽  
Author(s):  
Stephanie Law ◽  
Amrita Daftary ◽  
Max O'Donnell ◽  
Nesri Padayatchi ◽  
Liviana Calzavara ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychosocial Support ◽  
Retention In Care ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Material Support ◽  
Loss To Follow Up ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Likelihood Approach

The global loss to follow-up (LTFU) rate among drug-resistant tuberculosis (DR-TB) patients remains high at 15%. We conducted a systematic review to explore interventions to reduce LTFU during DR-TB treatment.We searched for studies published between January 2000 and December 2017 that provided any form of psychosocial or material support for patients with DR-TB. We estimated point estimates and 95% confidence intervals of the proportion LTFU. We performed subgroup analyses and pooled estimates using an exact binomial likelihood approach.We included 35 DR-TB cohorts from 25 studies, with a pooled proportion LTFU of 17 (12–23)%. Cohorts that received any form of psychosocial or material support had lower LTFU rates than those that received standard care. Psychosocial support throughout treatment, via counselling sessions or home visits, was associated with lower LTFU rates compared to when support was provided through a limited number of visits or not at all.Our review suggests that psychosocial support should be provided throughout DR-TB treatment in order to reduce treatment LTFU. Future studies should explore the potential of providing self-administered therapy complemented with psychosocial support during the continuation phase.

1216: Oral Treatment with a Vitamin D3 Analogue Shows Anti Inflammatory Effects and Reduces Bladder Overactivity in Rodent Models of Chronic Cystitis

2005 ◽  
Vol 173 (4S) ◽  
pp. 330-330
Author(s):  
Peter Zvara ◽  
Fabio Benigni ◽  
Enrico Baroni ◽  
Marija Zecevic ◽  
Antonia Monno ◽  
...  
Keyword(s):  
Vitamin D3 ◽  
Oral Treatment ◽  
Rodent Models ◽  
Chronic Cystitis ◽  
Anti Inflammatory
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