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dc.contributor.authorMohr-Holland, E
dc.contributor.authorReuter, A
dc.contributor.authorFurin, J
dc.contributor.authorGarcia-Prats, A
dc.contributor.authorDe Azevedo, V
dc.contributor.authorMudaly, V
dc.contributor.authorKock, Y
dc.contributor.authorTrivino-Duran, L
dc.contributor.authorIsaakidis, P
dc.contributor.authorHughes, J
dc.date.accessioned2020-06-23T19:22:39Z
dc.date.available2020-06-23T19:22:39Z
dc.date.issued2020-03-03
dc.date.submitted2020-04-17
dc.identifier.pmid32154506
dc.identifier.doi10.1016/j.eclinm.2020.100290
dc.identifier.urihttp://hdl.handle.net/10144/619653
dc.description.abstractBACKGROUND: Limited data exist on the use of bedaquiline and delamanid in adolescents with rifampicin-resistant tuberculosis (RR-TB). We describe RR-TB treatment of adolescents (10-19 years) with injectable-free regimens containing these drugs in Khayelitsha, South Africa. METHODS: This retrospective study included adolescents initiating injectable-free RR-TB treatment regimens containing bedaquiline and/or delamanid from February 2015 to June 2018. We report adverse events (AEs) of interest, sputum culture conversion (SCC), and final end-of-treatment outcomes. FINDINGS: Twenty-two patients were included; median age at treatment initiation was 17 years (interquartile range [IQR] 15-18), and six (27%) were HIV-positive (median CD4 count 191 cells/mm3 [IQR 157-204]). Eight (36%) patients had RR-TB with fluoroquinolone resistance; ten (45%), eight (36%), and four (18%) patients received regimens containing bedaquiline, delamanid, or the combination of bedaquiline and delamanid, respectively. The median durations of exposure to bedaquiline and delamanid were 5·6 (IQR 5·5-8·4) and 9·4 (IQR 5·9-14·4) months, respectively. There were 49 AEs of interest which occurred in 17 (77%) patients. Fourteen (64%) patients had pulmonary TB with positive sputum cultures at bedaquiline and/or delamanid initiation; among these SCC at month 6 was 79%. Final end-of-treatment outcomes for the 22 adolescent were: 17 (77%) successfully treated, two (9%) lost-to-follow-up, two (9%) treatment failed, and one (5%) died. INTERPRETATION: This study found that injectable-free regimens containing bedaquiline and/or delamanid in a programmatic setting were effective and well tolerated in adolescents and should be routinely provided for RR-TB treatment in this age group as recommended by the World Health Organisation.en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.rightsWith thanks to Elsevier.en_US
dc.titleInjectable-free regimens containing bedaquiline, delamanid, or both for adolescents with rifampicin-resistant tuberculosis in Khayelitsha, South Africaen_US
dc.typeArticle
dc.identifier.eissn2589-5370
dc.identifier.journalEClinicalMedicineen_US
dc.source.journaltitleEClinicalMedicine
dc.source.volume20
dc.source.beginpage100290
dc.source.endpage
refterms.dateFOA2020-06-23T19:22:40Z
dc.source.countryEngland


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