Publications
Human rights: finding the right balance for rifampicin-resistant TB treatment Institute of Tropical Medicine
Management of falsepositive rifampicin resistant Xpert MTB/RIF Institute of Tropical Medicine
Prevalence and drivers of false-positive rifampicin-resistant Xpert MTB/RIF results: a prospective observational study in Rwanda Institute of Tropical Medicine
Background The Xpert MTB/RIF (Xpert) assay is used globally to rapidly diagnose tuberculosis and resistance to rifampicin. We investigated the frequency and predictors of false-positive findings of rifampicin resistance with Xpert.
Methods We did a prospective, observational study of individuals who were enrolled in a Rwandan nationwide diagnostic cohort study (DIAMA trial; NCT03303963). We included patients identified to have ...
Short-course regimen for multidrug-resistant tuberculosis: a decade of evidence Institute of Tropical Medicine
About ten years ago, the first results of the so-called "Bangladesh regimen", a short regimen lasting nine months instead of 20 months, revolutionized multidrug-resistant tuberculosis (MDR-TB) treatment. Similar short regimens were studied in different settings, relying for their efficacy on a later generation fluoroquinolone, either gatifloxacin, moxifloxacin, or levofloxacin. We review the published material on short MDR-TB regimens, ...
The perceived impact of isoniazid resistance on outcome of first-line rifampicin-throughout regimens is largely due to missed rifampicin resistance Institute of Tropical Medicine
BACKGROUND: Meta-analyses on impact of isoniazid-resistant tuberculosis informed the World Health Organization recommendation of a levofloxacin-strengthened rifampicin-based regimen. We estimated the effect of initial rifampicin resistance (Rr) and/or isoniazid resistance (Hr) on treatment failure or relapse. We also determined the frequency of missed initial and acquired Rr to estimate the impact of true Hr.
METHODS: Retrospective ...
Characterization of genomic variants associated with resistance to bedaquiline and delamanid in naive Mycobacterium tuberculosis clinical strains Institute of Tropical Medicine
The role of mutations in genes associated with phenotypic resistance to bedaquiline (BDQ) and delamanid (DLM) in Mycobacterium tuberculosis complex (MTBc) strains is poorly characterized. A clear understanding of the genetic variants' role is crucial to guide the development of molecular-based drug susceptibility testing (DST). In this work, we analyzed all mutations in candidate genomic regions associated with BDQ- and DLM-resistant ...
Standardised shorter regimens versus individualised longer regimens for rifampin- or multidrug-resistant tuberculosis Institute of Tropical Medicine
We sought to compare the effectiveness of two World Health Organization (WHO)-recommended regimens for the treatment of rifampin- or multidrug-resistant (RR/MDR) tuberculosis (TB): a standardised regimen of 9-12 months (the "shorter regimen") and individualised regimens of >= 20 months ("longer regimens").
We collected individual patient data from observational studies identified through systematic reviews and a public call for data. ...
World Health Organization 2018 treatment guidelines for rifampicin-resistant tuberculosis: uncertainty, potential risks and the way forward Institute of Tropical Medicine
The 2018 World Health Organization (WHO) treatment guidelines for multidrug-/rifampicin-resistant tuberculosis (MDR/RR-TB) give preference to all-oral long regimens lasting for 18-20 months. The guidelines strongly recommend combining bedaquiline, levofloxacin (or moxifloxacin) and linezolid, supplemented by cycloserine and/or clofazimine. The effectiveness of this combination in a long regimen has not been tested in any study to date, with ...
Reduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwanda Institute of Tropical Medicine
SETTING: In 2005, in response to the increasing prevalence of rifampicin-resistant tuberculosis (RR -TB) and poor treatment outcomes, Rwanda initiated the programmatic management of RR-TB, including expanded access to systematic rifampicin drug suscep-tibility testing (DST) and standardised treatment.
OBJECTIVE: To describe trends in diagnostic and treatment delays and estimate their effect on RR-TB mortality.
DESIGN: ...