Evaluating treatment outcomes stratified by regimen among drug-resistant TB patients in Sierra Leone
Abstract
SETTING Sierra Leone has a high burden of drug-resistant TB (DR-TB), managed at three treatment centres. OBJECTIVE To compare treatment success between BPaL (bedaquiline, pretomanid, and linezolid)/BPaLM (bedaquiline, pretomanid, linezolid, and moxifloxacin) and the standardised short and the individualised long regimens among DR-TB patients and identify predictors of unsuccessful outcomes. DESIGN Retrospective cohort study utilising routinely collected national DR-TB data from January 2022 to December 2024. RESULTS Among 598 DR-TB patients registered from 2022 to 2024, 571 with complete outcomes were analysed. Overall treatment success was 80.2%, highest with BPaL/BPaLM (87.1%) compared with the standardised short (78.8%) and individualised long regimens (70.4%). Adjusted analyses showed BPaL/BPaLM remained strongly associated with higher success than the individualised long (adjusted risk ratio [aRR] 2.89; 95% confidence interval [CI] 1.80–4.64) and standardised short regimens (aRR 1.46; 95% CI 1.04–2.05). HIV co-infection and underweight body mass index independently predicted poor outcomes. Findings were consistent across propensity-weighted and sensitivity analyses. CONCLUSION Under routine programmatic conditions in Sierra Leone, BPaL/BPaLM achieved higher treatment success than standardised short or individualised long regimens. However, HIV co-infection and undernutrition predicted poorer outcomes, underscoring the need for integrated nutritional support, expanded…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
Read the paper
Related studies
- Synthesis, In Vitro and In Silico Molecular Docking Studies of Novel Phthalimide–Pyrimidine Hybrid Analogues to Thalidomide as Potent Antitubercular Agents
- Exploring the inhibitory performance of expired moxifloxacin and norfloxacin on copper corrosion in saline environment
- Molecular investigation of antimicrobial peptides against Helicobacter pylori proteins using a peptide-protein docking approach
- Screening of novel narrow-spectrum benzofuroxan derivatives for the treatment of multidrug-resistant tuberculosis through in silico, in vitro, and in vivo approaches
- Synthesis, Characterization, Anticancer, Antioxidant, and In Silico Evaluation of Semicarbazides and Thiosemicarbazides
- Fast and accurate prediction of drug induced proarrhythmic risk with sex specific cardiac emulators
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.