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Int J Tuberc Lung Dis. 2014 Aug;18(8):912-8. doi: 10.5588/ijtld.13.0028.

Treatment for LTBI in contacts of MDR-TB patients, Federated States of Micronesia, 2009-2012.

Author information

1
<label>*</label>Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.
2
<label><sup>‡</sup></label>Chuuk State TB Program, Ministry of Health, Chuuk, Federated States of Micronesia.
3
<label><sup>¶</sup></label>Tuberculosis Control Section, San Francisco Department of Public Health, San Francisco, California, USA.

Abstract

SETTING:

Few studies have shown the operational feasibility, safety, tolerability, or outcomes of multidrug-resistant latent tuberculous infection (MDR LTBI) treatment. After two simultaneous multidrug-resistant tuberculosis (MDR-TB) outbreaks in Chuuk, Federated States of Micronesia, infected contacts were offered a 12-month fluoroquinolone (FQ) based MDR LTBI treatment regimen.

DESIGN:

Between January 2009 and February 2012, 119 contacts of MDR-TB patients were followed using a prospective observational study design. After MDR-TB disease was excluded, 12 months of daily FQ-based preventive treatment of MDR LTBI was provided by directly observed therapy.

RESULTS:

Among the 119 infected contacts, 15 refused, while 104 began treatment for MDR LTBI. Of the 104 who initiated treatment, 93 (89%) completed treatment, while 4 contacts discontinued due to adverse effects. None of the 104 contacts who undertook MDR LTBI treatment of any duration developed MDR-TB disease; however, 3 of 15 contacts who refused and 15 unidentified contacts developed MDR-TB disease.

CONCLUSION:

Providing treatment for MDR LTBI can be accomplished in a resource-limited setting, and contributed to preventing MDR-TB disease. The Chuuk TB program implemented treatment of MDR LTBI with an 89% completion rate. The MDR LTBI regimens were safe and well tolerated, and no TB cases occurred among persons treated for MDR LTBI.

Comment in

PMID:
25199004
PMCID:
PMC4730114
DOI:
10.5588/ijtld.13.0028
[Indexed for MEDLINE]
Free PMC Article

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