{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:05:00Z","timestamp":1790687100909,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:00:00Z","timestamp":1609200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>At the end of 2018, South Africa updated its all-oral regimen, to include bedaquiline (BDQ) and 2 months of linezolid (LZD) for all patients initiating the shorter 9\u201312 months regimen for rifampicin-resistant tuberculosis (RR-TB). We assessed a group of patients in rural KwaZulu-Natal for safety and effectiveness of this treatment regimen under programmatic conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort analysis on RR-TB patients treated with a standardized all-oral short regimen between 1 July 2018 and 30 April 2019 in 3 facilities in King Cetshwayo District. An electronic register (EDR web) and facility-based clinical charts were used to collect variables, which were entered into an Epi-Info database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our cohort included 117 patients; 68.4% (95% confidence interval [CI]: 59.3\u201376.3) tested positive for human immunodeficiency virus (HIV). The median time to culture conversion was 56 days (95% CI: 50\u201357). Treatment success was achieved in 75.2% (95% CI: 66.5\u201382.3) of patients. Mortality within the cohort was 12.8% (95% CI: 7.8\u201320.3). Anemia was the most frequent severe adverse event (AE). The median time to develop severe anemia was 7.1 weeks (interquartile range [IQR] 4.0\u201312.9) after treatment initiation. LZD was interrupted in 25.2% (95% CI: 17.8\u201334.5) of participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An all-oral shorter regimen, including BDQ and LZD as core drugs for the treatment of RR-TB, shows good outcomes, in a high HIV burden rural setting. AEs are common, especially for LZD, but could be managed in the program setting. Support is needed when introducing new regimens to train staff in the monitoring, management, and reporting of AEs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1894","type":"journal-article","created":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T08:15:50Z","timestamp":1608797750000},"page":"e3563-e3571","source":"Crossref","is-referenced-by-count":37,"title":["Safety and Effectiveness of an All-Oral, Bedaquiline-Based, Shorter Treatment Regimen for Rifampicin-Resistant Tuberculosis in High Human Immunodeficiency Virus (HIV) Burden Rural South Africa: A Retrospective Cohort Analysis"],"prefix":"10.1093","volume":"73","author":[{"given":"Ilse","family":"Tack","sequence":"first","affiliation":[{"name":"Medical Department, M\u00e9decins sans Fronti\u00e8res, Eshowe, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asnake","family":"Dumicho","sequence":"additional","affiliation":[{"name":"Monitoring and Evaluation Department, M\u00e9decins sans Fronti\u00e8res, Eshowe, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesbet","family":"Ohler","sequence":"additional","affiliation":[{"name":"Medical Department, M\u00e9decins sans Fronti\u00e8res, Eshowe, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Altynay","family":"Shigayeva","sequence":"additional","affiliation":[{"name":"Monitoring and Evaluation Department, M\u00e9decins sans Fronti\u00e8res, Eshowe, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abera Balcha","family":"Bulti","sequence":"additional","affiliation":[{"name":"Medical Department, M\u00e9decins sans Fronti\u00e8res, Eshowe, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"White","sequence":"additional","affiliation":[{"name":"Medical Department, M\u00e9decins sans Fronti\u00e8res, Eshowe, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mduduzi","family":"Mbatha","sequence":"additional","affiliation":[{"name":"King Cetshwayo District TB coordinator, National Department of Health, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Furin","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7881-1554","authenticated-orcid":false,"given":"Petros","family":"Isaakidis","sequence":"additional","affiliation":[{"name":"South African Medical Unit Operational Research Department, M\u00e9decins sans Fronti\u00e8res, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,29]]},"reference":[{"key":"2021110300353079100_CIT0001","author":"World Health Organization","year":"2019"},{"key":"2021110300353079100_CIT0002","doi-asserted-by":"crossref","first-page":"177","DOI":"10.5588\/ijtld.15.0962","article-title":"Identification of patients who could benefit from bedaquiline or delamanid: a multisite MDR-TB cohort study","volume":"20","author":"Bonnet","year":"2016","journal-title":"Int J Tuberc Lung Dis"},{"key":"2021110300353079100_CIT0003","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/S0140-6736(18)31644-1","article-title":"Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis","volume":"392","author":"Ahmad","year":"2018","journal-title":"Lancet"},{"key":"2021110300353079100_CIT0004","doi-asserted-by":"crossref","first-page":"936","DOI":"10.3201\/eid2505.181823","article-title":"Outcomes of bedaquiline treatment in patients with multidrug-resistant tuberculosis","volume":"25","author":"Mbuagbaw","year":"2019","journal-title":"Emerg Infect Dis"},{"key":"2021110300353079100_CIT0005","author":"World Health Organization","year":"2019"},{"key":"2021110300353079100_CIT0006","doi-asserted-by":"crossref","first-page":"e93","DOI":"10.1164\/rccm.201909-1874ST","article-title":"Treatment of drug-resistant tuberculosis. an official ATS\/CDC\/ERS\/IDSA clinical practice guideline","volume":"200","author":"Nahid","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2021110300353079100_CIT0007","author":"SADoH","year":"2018"},{"key":"2021110300353079100_CIT0008","volume-title":"District health barometer 2017\/18","author":"Massyn","year":"2019"},{"key":"2021110300353079100_CIT0009","author":"Conan","year":"2019"},{"key":"2021110300353079100_CIT0010","author":"World Health Organization","year":"2020"},{"key":"2021110300353079100_CIT0011","author":"EndTB Consortium","year":"2018"},{"key":"2021110300353079100_CIT0012","author":"DoHKZN","year":"2020"},{"key":"2021110300353079100_CIT0013","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.5588\/ijtld.20.0048","article-title":"Treatment outcomes in patients with drug-resistant TB-HIV co-infection treated with bedaquiline and linezolid","volume":"24","author":"Padayatchi","year":"2020","journal-title":"Int J Tuberc Lung Dis"},{"key":"2021110300353079100_CIT0014","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.01528-2018","article-title":"High treatment success rate for multidrug- resistant and extensively drug-resistant tuberculosis using a bedaquiline-containing treatment regimen","author":"Ndjeka","year":"2018","journal-title":"Eur Respir J"},{"key":"2021110300353079100_CIT0015","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1056\/NEJMoa1811867","article-title":"A trial of a shorter regimen for rifampin-resistant tuberculosis","volume":"380","author":"Nunn","year":"2019","journal-title":"N Engl J Med"},{"key":"2021110300353079100_CIT0016","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.00544-2018","article-title":"Long-term bedaquiline-related treatment outcomes in patients with extensively drug-resistant tuberculosis from South Africa","volume":"51","author":"Olayanju","year":"2018","journal-title":"Eur Respir J"},{"key":"2021110300353079100_CIT0017","doi-asserted-by":"crossref","first-page":"329","DOI":"10.5588\/ijtld.19.0298","article-title":"Reduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwanda","volume":"24","author":"Ngabonziza","year":"2020","journal-title":"Int J Tuberc Lung Dis"},{"key":"2021110300353079100_CIT0018","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1056\/NEJMoa1313865","article-title":"Multidrug-resistant tuberculosis and culture conversion with bedaquiline","volume":"371","author":"Diacon","year":"2014","journal-title":"N Engl J Med"},{"key":"2021110300353079100_CIT0019","first-page":"987","article-title":"Hope rises out of despair\u202f: bedaquiline and linezolid for the treatment of drug-resistant TB","author":"Furin","year":"2020"},{"key":"2021110300353079100_CIT0020","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/S2213-2600(18)30235-2","article-title":"Effect of bedaquiline on mortality in South African patients with drug-resistant tuberculosis: a retrospective cohort study","volume":"6","author":"Schnippel","year":"2018","journal-title":"Lancet Respir Med"},{"key":"2021110300353079100_CIT0021","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1183\/13993003.00742-2017","article-title":"Bedaquiline-based treatment regimen for multidrug-resistant tuberculosis","volume":"49","author":"Olaru","year":"2017","journal-title":"Eur Respir J"},{"key":"2021110300353079100_CIT0022","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1056\/NEJMoa1201964","article-title":"Linezolid for treatment of chronic extensively drug-resistant tuberculosis","volume":"367","author":"Lee","year":"2012","journal-title":"N Engl J Med"},{"key":"2021110300353079100_CIT0023","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1056\/NEJMoa1901814","article-title":"Treatment of highly drug-resistant pulmonary tuberculosis","volume":"382","author":"Conradie","year":"2020","journal-title":"N Engl J Med"},{"key":"2021110300353079100_CIT0024","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/s12879-018-3021-0","article-title":"Factors affecting time to sputum culture conversion and treatment outcome of patients with multidrug-resistant tuberculosis in China","volume":"18","author":"Liu","year":"2018","journal-title":"BMC Infect Dis"},{"key":"2021110300353079100_CIT0025","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.4269\/ajtmh.17-0936","article-title":"Validity of time to sputum culture conversion to predict cure in patients with multidrug-resistant tuberculosis: a retrospective single-center study","volume":"98","author":"Javaid","year":"2018","journal-title":"Am J Trop Med Hyg"},{"key":"2021110300353079100_CIT0026","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1093\/jac\/dkx107","article-title":"Adverse drug reactions during drug-resistant TB treatment in high HIV prevalence settings: a systematic review and meta-analysis","volume":"72","author":"Schnippel","year":"2017","journal-title":"J Antimicrob Chemother"},{"key":"2021110300353079100_CIT0027","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S2213-2600(20)30047-3","article-title":"Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis","volume":"8","author":"Lan","year":"2020","journal-title":"Lancet Respir Med"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaa1894\/37905472\/ciaa1894.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/73\/9\/e3563\/41060975\/ciaa1894.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/73\/9\/e3563\/41060975\/ciaa1894.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T20:37:23Z","timestamp":1635885443000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/73\/9\/e3563\/6054965"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,29]]},"references-count":27,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,12,29]]},"published-print":{"date-parts":[[2021,11,2]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaa1894","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,11,1]]},"published":{"date-parts":[[2020,12,29]]}}}