• Research Protocol - Effectiveness of a simplified short regimen for Multidrug Resistant Tuberculosis treatment in Karakalpakstan, Uzbekistan

      du Cros, Philipp; Atadjan, Khamraev; Mirzagalib, Tillashaikhov; Nargiza, Parpieva; Zinaida, Tigay; Marjan, Sholtaeva; Tleubergen, Abdrasuliev; Betlam, Marttje; Wise, Emily; Ashagre, Teshome; Kuhlin, Johanna; Slyzkyi, Andrii; Taye, Alia; Dietrich, Sebastian; Nyangwa, Bern-Thomas; Greig, Jane; Hepple, Pamela; Cooke, Graham; Herboczek, Krzysztof; Asif, Muhammad; Achar, Jay; Berry, Catherine; Médecins Sans Frontières, Operational Center Amsterdam; Ministry of Health Uzbekistan; Ministry of Health Uzbekistan; Ministry of Health Uzbekistan; Ministry of Health Uzbekistan; Ministry of Health Uzbekistan; Ministry of Health Uzbekistan; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Imperial College London; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam; Médecins Sans Frontières, Operational Center Amsterdam (2014-07)
      Multidrug resistant tuberculosis (MDR TB) is a growing problem and few people have access to adequate diagnosis and treatment. The current recommended treatment regimen for MDR TB has a minimum of 20 months duration with high toxicity. Scale up of MDR TB treatment is associated with high default rates, and experience in the MSF programme in Uzbekistan shows that the current standard treatment greatly limits the ability to scale up to meet the high rates of MDR TB in the region. A prospective observational study has been designed. The primary outcome measure is the success rate at the end of treatment, and relapse and re-infection rates during 12 months of follow up after completion of treatment. Secondary outcome measures include rate of adverse events, interim outcomes with sputum smear microscopy and culture conversion rates at 4 and 6 months and time to conversion. Primary objective: To describe outcomes at end of treatment and relapse rate at 1 year following treatment completion of a short course (9-11 month) MDR TB treatment in programmatic conditions in Karakalpakstan, Uzbekistan. Secondary objectives: 1. To describe the adverse events of the treatment regimen 2. To evaluate risk factors for unfavorable outcomes (death, lost-to-follow up and failure) and relapse as a combined cohort. 3. To describe the rate of resistance amplification amongst patients with outcome failure.