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Atwine D., Orikiriza P., Taremwa I., Ayebare A., Logoose S., Mwanga-Amumpaire J., Jindani A., Bonnet Maryline. (2017). Predictors of delayed culture conversion among Ugandan patients. BMC Infectious Diseases, 17, art. 299 [8 p.]. ISSN 1471-2334

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Lien direct chez l'éditeur doi:10.1186/s12879-017-2335-7

Titre
Predictors of delayed culture conversion among Ugandan patients
Année de publication2017
Type de documentArticle référencé dans le Web of Science WOS:000400435700002
AuteursAtwine D., Orikiriza P., Taremwa I., Ayebare A., Logoose S., Mwanga-Amumpaire J., Jindani A., Bonnet Maryline.
SourceBMC Infectious Diseases, 2017, 17, p. art. 299 [8 p.]. p. art. 299 [8 p.] ISSN 1471-2334
RésuméBackground: Estimates of month-2 culture conversion, a proxy indicator of tuberculosis (TB) treatment efficacy in phase-2 trials can vary by culture-type and geographically with lower rates reported among African sites. The sub-study aimed at comparing TB detection rates of different culture media, within and across rifampicin-based regimens (R10, 15 and 20 mg/Kg) over a 6-month treatment follow-up period, and to establish predictors of month-2 culture non-conversion among HIV-negative TB patients enrolled at RIFATOX trial site in Uganda. Methods: Unlike in other Rifatox Trial sites, it is only in Uganda were Lowenstein-Jensen (LJ) and Mycobacteria growth indicator tube (MGIT) were used throughout 6-months for treatment monitoring. Conversion rates were compared at month-2, 4 and 6 across cultures and treatment-type. Binomial regression analysis performed for predictors of month-2 non-conversion. Results: Of the 100 enrolled patients, 45% had converted based on combined LJ and MGIT by month-2, with no significant differences across treatment arms, p = 0.721. LJ exhibited higher conversion rates than MGIT at month-2 (58.4% vs 56.0%, p = 0.0707) and month-4 (98.9% vs 88.4%, p = 0.0391) respectively, more so within the high-dose rifampicin arms. All patients had converted by month-6. Time-to-TB detection (TTD) on MGIT and social service jobs independently predict month-2 non-conversion. Conclusion: The month-2 culture conversion used in phase 2 clinical trials as surrogate marker of treatment efficacy is influenced by the culture method used for monitoring mycobacterial response to TB treatment. Therefore, multi-centric TB therapeutic trials using early efficacy endpoint should use the same culture method across sites. The Time-to-detection of MTB on MGIT prior to treatment and working in Social service jobs bear an increased risk of culture non-conversion at month-2.
Plan de classementEntomologie médicale / Parasitologie / Virologie [052] ; Santé : généralités [050]
Descr. géo.OUGANDA
LocalisationFonds IRD [F B010070020]
Identifiant IRDfdi:010070020
Lien permanenthttp://www.documentation.ird.fr/hor/fdi:010070020

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