High mortality associated with retreatment of tuberculosis in a clinic in Kampala, Uganda: a retrospective study.
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.
Section 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.
Carlos
C
Acuña-Villaorduña
Section 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.
Irene
I
Ayakaka
Section 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.
Scott
S
Dryden-Peterson
Section 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.
Susan
S
Nakubulwa
Section 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.
William
W
Worodria
Section 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.
Nancy
N
Reilly
Section 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.
Jennifer
J
Hosford
Section 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.
Kevin P
KP
Fennelly
Section 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.
Alphonse
A
Okwera
Section 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 edward.jones@bmc.org.
Edward C
EC
Jones-López
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D060085:Coinfection; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011718:Pyrazinamide / Q000627:therapeutic use; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use; D013307:Streptomycin / Q000627:therapeutic use; D015996:Survival Rate; D017211:Treatment Failure; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D014454:Uganda
D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin