Critically low treatment success rate in extensively drug-resistant tuberculosis patients in the Republic of Moldova

Abstract

Background. The updated definition by WHO global TB programme of XDR-TB refers to TB that is resistant to minimum one fluoroquinolone and with addition of one Group A anti-TB drug, highlights increasing emergence of resistance to new drugs, threat to global efforts, treatment complexities and poor treatment outcomes. Objective(s). To examine the Final treatment outcomes in adult patients of XDR-TB treated under the Moldova national tuberculosis control programme from January 2017 to December 2023. Materials and methods. A retrospective cohort observational study was conducted among adult patients of XDR-TB who had treatment between 2017-2023 in the Republic of Moldova. The updated definition by WHO in 2021 of XDR-TB was applied on clinical and microbiological extracted data from the SIME-TB national database and the variables were analyzed descriptively. Results. The study included 66 patients of XDR-TB treated between 2017-2023, the mean age was 46.68± 1.62 years, the majority were males comprising 77.3 % of the sample. Resistance to bedaquiline was observed in 33 patients (50%), and resistance to linezolid was observed in 47 patients (71.2%). Treatment outcome revealed that success was observed in only 15 patients (22.7%), Treatment failure was seen in 17 patients (25.7%) and 28 patients died (42.4%). The rate of treatment success recorded in the current cohort study was considerably lower than the national average for the same time, which typically falls between 49% to 70%. Conclusion(s). The findings of study reveal a critically low treatment success rate among the Moldovan patients with extensively drug-resistant tuberculosis (XDR-TB), clearly highlighting the pressing need for effective tools for timely detection of additional resistance in mycobacterium tuberculosis strains.