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.
