Simulation of Conditions and Results of Implementation of Short-Course Treatment Regimes in Tuberculosis Patients

Abstract

The objective: to study the conditions of implementation of short-course (4 and 9 months) treatment regimens in tuberculosis patients and simulate their impact on the frequency of early treatment interruption (ETI) by patients.Subjects and Methods. Data on the treatment duration from enrollment to chemotherapy interruption in 8,029 tuberculosis patients were studied. Data were obtained from the Federal Register of Tuberculosis Cases for 2020. Of these, 3,379 patients were treated with regimens for susceptible or suspected susceptible tuberculous mycobacteria excluding isoniazid resistant tuberculosis, and 4,650 patients received regimens for rifampicin-resistant tuberculous mycobacteria.Results. The median duration of treatment from onset to ETI was 124 (95% CI 120-128) days in 3,379 patients, 224 (95% CI 215-233) days in 4,650 patients, or 170 (95% CI 157-181) days if there was a history of treatment interruption. Simulation of ETI terms when short-course chemotherapy regimens were introduced has shown that we can expect a 2-fold decrease in the proportion of patients who interrupted chemotherapy among patients with preserved/suspected susceptibility of tuberculous mycobacteria, and 1.3-1.7-fold decrease among patients with confirmed/presumed drug resistance of tuberculous mycobacteria at least to rifampicin.