Strategies for reducing treatment default in drug-resistant tuberculosis: systematic review and meta-analysis [Review article].

Hdl Handle:
http://hdl.handle.net/10144/264593
Title:
Strategies for reducing treatment default in drug-resistant tuberculosis: systematic review and meta-analysis [Review article].
Authors:
Toczek, A; Cox, H; Cros, P du; Cooke, G; Ford, N
Journal:
The International Journal of Tuberculosis and Lung =Disease : the official journal of the International Union against Tuberculosis and Lung Disease
Abstract:
BACKGROUND: Scaling up treatment for multidrug-resistant tuberculosis is a global health priority. However, current treatment regimens are long and associated with side effects, and default rates are consequently high. This systematic review aimed to identify strategies for reducing treatment default.METHODS: We conducted a systematic search up to May 2012 to identify studies describing interventions to support patients receiving treatment for multidrug-resistant tuberculosis (MDR-TB). The potential influence of study interventions were explored through subgroup analyses.RESULTS: A total of 75 studies provided outcomes for 18 294 patients across 31 countries. Default rates ranged from 0.5% to 56%, with a pooled proportion of 14.8% (95%CI 12.4-17.4). Strategies identified to be associated with lower default rates included the engagement of community health workers as directly observed treatment (DOT) providers, the provision of DOT throughout treatment, smaller cohort sizes and the provision of patient education.CONCLUSION: Current interventions to support adherence and retention are poorly described and based on weak evidence. This review was able to identify a number of promising, inexpensive interventions feasible for implementation and scale-up in MDR-TB programmes. The high default rates reported from many programmes underscore the pressing need to further refine and evaluate simple intervention packages to support patients.
Issue Date:
4-Dec-2012
URI:
http://hdl.handle.net/10144/264593
DOI:
10.5588/ijtld.12.0537
PubMed ID:
23211716
Language:
en
ISSN:
1815-7920
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorToczek, Aen_GB
dc.contributor.authorCox, Hen_GB
dc.contributor.authorCros, P duen_GB
dc.contributor.authorCooke, Gen_GB
dc.contributor.authorFord, Nen_GB
dc.date.accessioned2013-01-08T20:26:23Z-
dc.date.available2013-01-08T20:26:23Z-
dc.date.issued2012-12-04-
dc.identifier.citationStrategies for reducing treatment default in drug-resistant tuberculosis: systematic review and meta-analysis [Review article]. 2012: Int. J. Tuberc. Lung Dis.en_GB
dc.identifier.issn1815-7920-
dc.identifier.pmid23211716-
dc.identifier.doi10.5588/ijtld.12.0537-
dc.identifier.urihttp://hdl.handle.net/10144/264593-
dc.description.abstractBACKGROUND: Scaling up treatment for multidrug-resistant tuberculosis is a global health priority. However, current treatment regimens are long and associated with side effects, and default rates are consequently high. This systematic review aimed to identify strategies for reducing treatment default.METHODS: We conducted a systematic search up to May 2012 to identify studies describing interventions to support patients receiving treatment for multidrug-resistant tuberculosis (MDR-TB). The potential influence of study interventions were explored through subgroup analyses.RESULTS: A total of 75 studies provided outcomes for 18 294 patients across 31 countries. Default rates ranged from 0.5% to 56%, with a pooled proportion of 14.8% (95%CI 12.4-17.4). Strategies identified to be associated with lower default rates included the engagement of community health workers as directly observed treatment (DOT) providers, the provision of DOT throughout treatment, smaller cohort sizes and the provision of patient education.CONCLUSION: Current interventions to support adherence and retention are poorly described and based on weak evidence. This review was able to identify a number of promising, inexpensive interventions feasible for implementation and scale-up in MDR-TB programmes. The high default rates reported from many programmes underscore the pressing need to further refine and evaluate simple intervention packages to support patients.en_GB
dc.languageENG-
dc.language.isoenen
dc.rightsArchived with thanks to The International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Diseaseen_GB
dc.titleStrategies for reducing treatment default in drug-resistant tuberculosis: systematic review and meta-analysis [Review article].en
dc.identifier.journalThe International Journal of Tuberculosis and Lung =Disease : the official journal of the International Union against Tuberculosis and Lung Diseaseen_GB

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