Desenlaces del tratamiento de pacientes adultos con tuberculosis multiresistente y con resistencia extendida. Revisión sistemática.

Abstract

Introduction: Tuberculosis (TB) is considered a highly prevalent disease worldwide and a public health problem by the decrease in the cure rate since the appearance of multi-resistant TB and widespread, so it is necessary to design emerging management strategies to slow down the increasing incidence of TB worldwide. Methods: We performed a systematic literature research through PubMed and HINARI directing the search to studies evaluating outcomes of MDR TB management according to the goals set by last WHO guide. Results: We collected 9 articles tracking a cohort in different parts worldwide according to the inclusion criteria, in the sample collected from these 9 articles, 4720 people were treated from the beginning, 4163 (88%) of the cases were identified as MDR TB and 557 (12%) cases accounted for XDR TB. From this sample were excluded patients transferred to other institutions, leaving a total of 4455. We found that the overall cure rate exceeds 50% of the sample with individualized management however; mortality remains representative and higher compared with other variables. Conclusions: The studies evaluated multiple management strategies in different countries without conclusive results about a standardized management strategy. Elaborate a meta-analysis is not possible due to the poor characterization of the treatment schedules used in each study and poorly delineated definitions.