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High mortality associated with retreatment of tuberculosis in a clinic in Kampala, Uganda: a retrospective study
Carlos Acuña-Villaorduña1, Irene Ayakaka1, Scott Dryden-Peterson1
1Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts; Makerere University-Boston Medical Center Research Collaboration, Kampala, Uganda; Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Medical Research Council-Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda; Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda; Section of Infectious Diseases, Department of Medicine, New Jersey Medical School-Rutgers University, Newark, New Jersey; Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida, Gainesville, Florida; Mulago Hospital Tuberculosis Clinic, Mulago Hospital, Kampala, Uganda.
Abstract:
The World Health Organization recommends for tuberculosis retreatment a regimen of isoniazid (H), rifampicin (R), ethambutol (E), pyrazinamide (Z), and streptomycin (S) for 2 months, followed by H, R, E, and Z for 1 month and H, R, and E for 5 months. Using data from the National Tuberculosis and Leprosy Program registry, this study determined the long-term outcome under programmatic conditions of patients who were prescribed the retreatment regimen in Kampala, Uganda, between 1997 and 2003. Patients were traced to determine their vital status; 62% (234/377) patients were found dead. Having ≤ 2 treatment courses and not completing retreatment were associated with mortality in adjusted analyses.