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...

Full description

Saved in:
Bibliographic Details
Published in:Emerging infectious diseases 2021-03, Vol.27 (3), p.805-812
Main Authors: Malik, Amyn A, Gandhi, Neel R, Lash, Timothy L, Cranmer, Lisa M, Omer, Saad B, Ahmed, Junaid F, Siddiqui, Sara, Amanullah, Farhana, Khan, Aamir J, Keshavjee, Salmaan, Hussain, Hamidah, Becerra, Mercedes C
Format: Article
Language:English
Subjects:
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
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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%.
ISSN:1080-6040
1080-6059
DOI:10.3201/eid2703.203916