Effectiveness of Preventive Therapy for Persons Exposed at Home to Drug-Resistant Tuberculosis, Karachi, Pakistan
In Karachi, Pakistan, a South Asian megacity with a high prevalence of tuberculosis (TB) and low HIV prevalence, we assessed the effectiveness of fluoroquinolone-based preventive therapy for drug-resistant (DR) TB exposure. During February 2016–March 2017, high-risk household contacts of DR TB patie...
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| Vydáno v: | Emerging infectious diseases Ročník 27; číslo 3; s. 805 - 812 |
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| Hlavní autoři: | , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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United States
U.S. National Center for Infectious Diseases
01.03.2021
Centers for Disease Control and Prevention |
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| ISSN: | 1080-6040, 1080-6059, 1080-6059 |
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| Abstract | In Karachi, Pakistan, a South Asian megacity with a high prevalence of tuberculosis (TB) and low HIV prevalence, we assessed the effectiveness of fluoroquinolone-based preventive therapy for drug-resistant (DR) TB exposure. During February 2016–March 2017, high-risk household contacts of DR TB patients began a 6-month course of preventive therapy with a fluoroquinolone-based, 2-drug regimen. We assessed effectiveness in this cohort by comparing the rate and risk for TB disease over 2 years to the rates and risks reported in the literature. Of 172 participants, TB occurred in 2 persons over 336 person-years of observation. TB disease incidence rate observed in the cohort was 6.0/1,000 person-years. The incidence rate ratio ranged from 0.29 (95% CI 0.04–1.3) to 0.50 (95% CI 0.06–2.8), with a pooled estimate of 0.35 (95% CI 0.14–0.87). Overall, fluoroquinolone-based preventive therapy for DR TB exposure reduced risk for TB disease by 65%. |
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| AbstractList | In Karachi, Pakistan, a South Asian megacity with a high prevalence of tuberculosis (TB) and low HIV prevalence, we assessed the effectiveness of fluoroquinolone-based preventive therapy for drug-resistant (DR) TB exposure. During February 2016–March 2017, high-risk household contacts of DR TB patients began a 6-month course of preventive therapy with a fluoroquinolone-based, 2-drug regimen. We assessed effectiveness in this cohort by comparing the rate and risk for TB disease over 2 years to the rates and risks reported in the literature. Of 172 participants, TB occurred in 2 persons over 336 person-years of observation. TB disease incidence rate observed in the cohort was 6.0/1,000 person-years. The incidence rate ratio ranged from 0.29 (95% CI 0.04–1.3) to 0.50 (95% CI 0.06–2.8), with a pooled estimate of 0.35 (95% CI 0.14–0.87). Overall, fluoroquinolone-based preventive therapy for DR TB exposure reduced risk for TB disease by 65%. Fluoroquinolone-based preventive therapy reduced risk for tuberculosis disease by 65%. In Karachi, Pakistan, a South Asian megacity with a high prevalence of tuberculosis (TB) and low HIV prevalence, we assessed the effectiveness of fluoroquinolone-based preventive therapy for drug-resistant (DR) TB exposure. During February 2016–March 2017, high-risk household contacts of DR TB patients began a 6-month course of preventive therapy with a fluoroquinolone-based, 2-drug regimen. We assessed effectiveness in this cohort by comparing the rate and risk for TB disease over 2 years to the rates and risks reported in the literature. Of 172 participants, TB occurred in 2 persons over 336 person-years of observation. TB disease incidence rate observed in the cohort was 6.0/1,000 person-years. The incidence rate ratio ranged from 0.29 (95% CI 0.04–1.3) to 0.50 (95% CI 0.06–2.8), with a pooled estimate of 0.35 (95% CI 0.14–0.87). Overall, fluoroquinolone-based preventive therapy for DR TB exposure reduced risk for TB disease by 65%. |
| Audience | Professional Academic |
| Author | Keshavjee, Salmaan Amanullah, Farhana Omer, Saad B. Khan, Aamir J. Malik, Amyn A. Becerra, Mercedes C. Hussain, Hamidah Gandhi, Neel R. Lash, Timothy L. Cranmer, Lisa M. Ahmed, Junaid F. Siddiqui, Sara |
| Author_xml | – sequence: 1 givenname: Amyn A. surname: Malik fullname: Malik, Amyn A. – sequence: 2 givenname: Neel R. surname: Gandhi fullname: Gandhi, Neel R. – sequence: 3 givenname: Timothy L. surname: Lash fullname: Lash, Timothy L. – sequence: 4 givenname: Lisa M. surname: Cranmer fullname: Cranmer, Lisa M. – sequence: 5 givenname: Saad B. surname: Omer fullname: Omer, Saad B. – sequence: 6 givenname: Junaid F. surname: Ahmed fullname: Ahmed, Junaid F. – sequence: 7 givenname: Sara surname: Siddiqui fullname: Siddiqui, Sara – sequence: 8 givenname: Farhana surname: Amanullah fullname: Amanullah, Farhana – sequence: 9 givenname: Aamir J. surname: Khan fullname: Khan, Aamir J. – sequence: 10 givenname: Salmaan surname: Keshavjee fullname: Keshavjee, Salmaan – sequence: 11 givenname: Hamidah surname: Hussain fullname: Hussain, Hamidah – sequence: 12 givenname: Mercedes C. surname: Becerra fullname: Becerra, Mercedes C. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33624580$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3390_pathogens11101189 crossref_primary_10_1093_cid_ciae024 crossref_primary_10_3390_tropicalmed7120418 crossref_primary_10_1093_cid_ciaf069 crossref_primary_10_1016_j_cmi_2023_09_015 crossref_primary_10_1093_ofid_ofad087 crossref_primary_10_25100_cm_v56i1_5918 crossref_primary_10_1016_j_heliyon_2024_e30942 crossref_primary_10_7759_cureus_25454 crossref_primary_10_1016_S2213_2600_23_00084_X crossref_primary_10_3390_pathogens12050728 crossref_primary_10_2147_IDR_S531874 crossref_primary_10_1016_S1473_3099_25_00157_4 crossref_primary_10_1056_NEJMoa2314318 crossref_primary_10_3390_tropicalmed8020089 |
| Cites_doi | 10.1093/cid/ciz438 10.1016/S1473-3099(17)30447-4 10.1183/13993003.02414-2019 10.1183/13993003.01179-2015 10.1093/cid/cix208 10.1201/9781351249980-21 10.1097/INF.0b013e3181783aca 10.1093/cid/ciaa613 10.1371/journal.pone.0215322 10.1164/rccm.201406-1159OC 10.5588/ijtld.13.0028 10.1093/cid/cit655 10.1542/peds.109.5.765 10.1093/cid/cit643 10.1183/13993003.00224-2020 10.1183/09031936.00070812 10.1136/bmj.l5894 10.1093/cid/ciz502 10.1183/09031936.00205512 10.3201/eid2103.141313 10.1093/cid/ciaa327 10.1097/INF.0b013e31826f6063 10.5588/ijtld.13.0593 10.1016/S0140-6736(10)61972-1 10.1097/INF.0000000000000260 |
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| Copyright | COPYRIGHT 2021 U.S. National Center for Infectious Diseases Published 2021. This article is a U.S. Government work and is in the public domain in the USA. |
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| Keywords | Karachi Pakistan bacteria antimicrobial resistance fluoroquinolone preventive therapy contact investigation drug-resistant tuberculosis infection tuberculosis and other mycobacteria latent infection prophylaxis |
| Language | English |
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| Snippet | In Karachi, Pakistan, a South Asian megacity with a high prevalence of tuberculosis (TB) and low HIV prevalence, we assessed the effectiveness of... Fluoroquinolone-based preventive therapy reduced risk for tuberculosis disease by 65%. In Karachi, Pakistan, a South Asian megacity with a high prevalence of... |
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| SubjectTerms | Age Antibiotics Antitubercular Agents - therapeutic use CME contact investigation Diabetes Disease prevention Dosage and administration Drug resistance drug-resistant tuberculosis infection Effectiveness of Preventive Therapy for Persons Exposed at Home to Drug-Resistant Tuberculosis, Karachi, Pakistan fluoroquinolone Households Humans latent infection Malnutrition Medicine, Preventive Megacities Methods Mycobacterium tuberculosis Pakistan Patients Prevention Preventive health services preventive therapy prophylaxis Quinolone antibacterial agents Quinolones Risk factors Tuberculosis Tuberculosis, Multidrug-Resistant - drug therapy |
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| Title | Effectiveness of Preventive Therapy for Persons Exposed at Home to Drug-Resistant Tuberculosis, Karachi, Pakistan |
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