Four francophone African countries recently shared their successful experience using a shortened regimen for treating patients with MDR-TB with representatives of other francophone countries at a Union workshop in Douala, Cameroon. This was the third MDR-TB workshop offered to provide training and an opportunity to exchange news about progress in managing MDR-TB.
After the 2008 workshop in Burkina Faso, Benin, Cameroon, Niger and Togo decided to treat their MDR patients with a short-course regimen similar to the one used in Bangladesh with excellent results (Van Deun et al. Am J Respir Crit Care Med. 2010 Sep 1;182(5):684-92). The only differences are that the regimen used in the African countries lasts 12 months instead of the 9 months, and it includes prothionamide throughout the continuation phase.
The treatment results the countries reported generated great interest: 90% "cured" among the 120 patients (20% HIV positive) who received the short-course regimen versus a 59% "success" rate among the 339 patients who received the long-course regimen (17% "cured", 42% "treatment completed"). No failures and no relapses have been reported so far for the short-course regimen.
These results are very encouraging, and the sputum culture conversion arrives very early, so the four countries are planning to reduce the total length of the MDR treatment to 9 months, as in Bangladesh. And, last but not least, so far the cost of the drugs for the short-course regimen is only 180€ (as opposed to more than 2,000€ for long regimen).
All of the countries present at the workshop were impressed with these results and are willing to test these short-course regimens. The 32 participants came from 10 different francophone countries of sub-Saharan Africa – Benin, Burkina Faso, Burundi, Cameroon, Côte d'Ivoire, Mali, Niger, DR Congo, Rwanda and Togo. Two observers from the World Health Organization in Geneva also attended.
Funding for this workshop and other French-language educational activities and resources was provided by the Agence Française de Développement (AFD).