title: Treatment outcomes for patients with multidrug-resistant tuberculosis in post-earthquake Port-au-Prince, Haiti.
abstract: We report outcomes and 12-month survival for the first cohort of patients to undergo multidrug-resistant tuberculosis (MDR-TB) treatment after the earthquake in Haiti. From March 3, 2010 to March 28, 2013, 110 patients initiated treatment of laboratory-confirmed MDR-TB at the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Center in Port-au-Prince, Haiti. Twenty-seven patients (25%) were human immunodeficiency virus (HIV)-positive. As of October 31, 2013, 95 (86%) patients were either cured or alive on treatment, 4 (4%) patients defaulted, and 11 (10%) patients died. Culture conversion occurred by 30 days in 14 (13%) patients, 60 days in 49 (45%) patients, and 90 days in 81 (74%) patients. The probabilities of survival to 12 months were 96% (95% confidence interval [95% CI] = 89-99) and 85% (95% CI = 64-94) for HIV-negative and -positive patients, respectively. Despite adverse conditions, outcomes for patients with MDR-TB are highly encouraging. Major efforts are underway to scale up community directly observed therapy and expand care to other regions of Haiti.
authors: Les Centres Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti; Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Masters of Science in Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Infectious Diseases, Center for Global Health, Weill Cornell Medical College, New York, New York makchuk@gmail.com.
authors: Macarthur
authors: M
authors: Charles
authors: Les Centres Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti; Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Masters of Science in Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Infectious Diseases, Center for Global Health, Weill Cornell Medical College, New York, New York.
authors: Stalz Charles
authors: SC
authors: Vilbrun
authors: Les Centres Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti; Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Masters of Science in Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Infectious Diseases, Center for Global Health, Weill Cornell Medical College, New York, New York.
authors: Serena P
authors: SP
authors: Koenig
authors: Les Centres Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti; Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Masters of Science in Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Infectious Diseases, Center for Global Health, Weill Cornell Medical College, New York, New York.
authors: Lauren M
authors: LM
authors: Hashiguchi
authors: Les Centres Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti; Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Masters of Science in Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Infectious Diseases, Center for Global Health, Weill Cornell Medical College, New York, New York.
authors: Marie Marcelle
authors: MM
authors: Mabou
authors: Les Centres Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti; Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Masters of Science in Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Infectious Diseases, Center for Global Health, Weill Cornell Medical College, New York, New York.
authors: Oksana
authors: O
authors: Ocheretina
authors: Les Centres Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti; Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Masters of Science in Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Infectious Diseases, Center for Global Health, Weill Cornell Medical College, New York, New York.
authors: Jean W
authors: JW
authors: Pape
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D023801:Directly Observed Therapy; D004190:Disasters; D055866:Earthquakes; D005260:Female; D005500:Follow-Up Studies; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications* / Q000188:drug therapy; D006205:Haiti; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents