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  1. Article ; Online: Balancing adjunctive therapy for tuberculosis treatment.

    Ndjeka, Norbert / Furin, Jennifer

    The Lancet. Infectious diseases

    2023  Volume 23, Issue 7, Page(s) 771–772

    MeSH term(s) Humans ; Tuberculosis/drug therapy ; Tuberculosis, Pulmonary/drug therapy ; Antitubercular Agents/therapeutic use ; Mycobacterium tuberculosis
    Chemical Substances Antitubercular Agents
    Language English
    Publishing date 2023-03-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2061641-7
    ISSN 1474-4457 ; 1473-3099
    ISSN (online) 1474-4457
    ISSN 1473-3099
    DOI 10.1016/S1473-3099(23)00136-6
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    Zs.A 5743: Show issues Location:
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  2. Article ; Online: Effect of bedaquiline on mortality in South African patients with drug-resistant tuberculosis - Authors' reply.

    Ndjeka, Norbert

    The Lancet. Respiratory medicine

    2019  Volume 6, Issue 12, Page(s) e57

    MeSH term(s) Diarylquinolines ; Humans ; Tuberculosis, Multidrug-Resistant
    Chemical Substances Diarylquinolines ; bedaquiline (78846I289Y)
    Language English
    Publishing date 2019-01-07
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(18)30451-X
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  3. Article ; Online: Bedaquiline and clofazimine: successes and challenges.

    Ndjeka, Norbert / Ismail, Nazir A

    The Lancet. Microbe

    2020  Volume 1, Issue 4, Page(s) e139–e140

    Language English
    Publishing date 2020-08-06
    Publishing country England
    Document type Journal Article
    ISSN 2666-5247
    ISSN (online) 2666-5247
    DOI 10.1016/S2666-5247(20)30097-5
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  4. Article ; Online: Bedaquiline and clofazimine

    Norbert Ndjeka / Nazir A Ismail

    The Lancet Microbe, Vol 1, Iss 4, Pp e139-e

    successes and challenges

    2020  Volume 140

    Keywords Medicine (General) ; R5-920 ; Microbiology ; QR1-502
    Language English
    Publishing date 2020-08-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Bedaquiline-Resistant Tuberculosis Associated with

    Omar, Shaheed V / Ismail, Farzana / Ndjeka, Norbert / Kaniga, Koné / Ismail, Nazir A

    The New England journal of medicine

    2022  Volume 386, Issue 1, Page(s) 93–94

    MeSH term(s) Antitubercular Agents/therapeutic use ; Diarylquinolines/therapeutic use ; Drug Resistance, Bacterial/genetics ; Humans ; Mutation ; Mycobacterium tuberculosis/genetics ; Tuberculosis/drug therapy ; Tuberculosis/microbiology
    Chemical Substances Antitubercular Agents ; Diarylquinolines ; bedaquiline (78846I289Y)
    Language English
    Publishing date 2022-01-05
    Publishing country United States
    Document type Letter
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc2103049
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  6. Article ; Online: Successful Multidrug-Resistant Tuberculosis Treatment Without HIV Viral Suppression: A Missed Opportunity.

    Geiger, Keri / Patil, Amita / Budhathoki, Chakra / Dooley, Kelly E / Lowensen, Kelly / Ndjeka, Norbert / Ngozo, Jacqueline / Farley, Jason E

    Journal of acquired immune deficiency syndromes (1999)

    2023  Volume 94, Issue 3, Page(s) 253–261

    Abstract: Background: Coinfection with multidrug-resistant tuberculosis (MDR-TB) and HIV is common, but few published studies examine how undergoing MDR-TB treatment affects HIV disease indicators.: Methods: Using data from a nested, retrospective cohort of ... ...

    Abstract Background: Coinfection with multidrug-resistant tuberculosis (MDR-TB) and HIV is common, but few published studies examine how undergoing MDR-TB treatment affects HIV disease indicators.
    Methods: Using data from a nested, retrospective cohort of people with HIV (PWH) and successful MDR-TB treatment outcomes, we built multivariable regression models to explore correlates of HIV viral suppression at MDR-TB treatment completion.
    Results: Among 531 PWH successfully treated for MDR-TB, mean age was 37.4 years (SD 10.2, interquartile range 30-43), 270 (50.8%) were male, 395 (74.4%) were virally suppressed at MDR-TB outcome, and 259 (48.8%) took bedaquiline. Older age (adjusted odds ratio [aOR] 1.04, 95% confidence interval [CI]: 1.01 to 1.06) increased odds of viral suppression, while having a prior TB episode (aOR 0.45, 95% CI: 0.31 to 0.64), having a detectable viral load at MDR-TB treatment initiation (aOR 0.17, 95% CI: 0.09 to 0.30), living in a township (aOR 0.49, 95% CI: 0.28 to 0.87), and being changed from efavirenz-based antiretroviral therapy (ART) to a protease inhibitor due to bedaquiline usage (aOR 0.19, 95% CI: 0.04 to 0.82) or not having an ART change while on bedaquiline (aOR 0.29, 95% CI: 0.11 to 0.75) lowered odds of viral suppression. Changing from efavirenz to nevirapine due to bedaquiline usage did not significantly affect odds of viral suppression (aOR 0.41, 95% CI: 0.16 to 1.04).
    Conclusions: Increased pill burden and adverse treatment effects did not significantly affect HIV viral suppression while switching ART to a protease inhibitor to accommodate bedaquiline or not changing ART while taking bedaquiline did, suggesting that PWH and MDR-TB may benefit from additional support if they must switch ART.
    MeSH term(s) Humans ; Male ; Adult ; Female ; HIV Infections/complications ; HIV Infections/drug therapy ; Antitubercular Agents/therapeutic use ; Retrospective Studies ; Tuberculosis, Multidrug-Resistant/drug therapy ; Treatment Outcome ; Antiviral Agents/therapeutic use ; Protease Inhibitors/therapeutic use
    Chemical Substances efavirenz (JE6H2O27P8) ; Antitubercular Agents ; Antiviral Agents ; Protease Inhibitors
    Language English
    Publishing date 2023-09-14
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 645053-2
    ISSN 1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
    ISSN (online) 1944-7884 ; 1077-9450
    ISSN 0897-5965 ; 0894-9255 ; 1525-4135
    DOI 10.1097/QAI.0000000000003268
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2442: Show issues Location:
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  7. Article ; Online: The epidemiology, transmission, diagnosis, and management of drug-resistant tuberculosis-lessons from the South African experience.

    Naidoo, Kogieleum / Perumal, Rubeshan / Cox, Helen / Mathema, Barun / Loveday, Marian / Ismail, Nazir / Omar, Shaheed Vally / Georghiou, Sophia B / Daftary, Amrita / O'Donnell, Max / Ndjeka, Norbert

    The Lancet. Infectious diseases

    2024  

    Abstract: Drug-resistant tuberculosis (DR-TB) threatens to derail tuberculosis control efforts, particularly in Africa where the disease remains out of control. The dogma that DR-TB epidemics are fueled by unchecked rates of acquired resistance in inadequately ... ...

    Abstract Drug-resistant tuberculosis (DR-TB) threatens to derail tuberculosis control efforts, particularly in Africa where the disease remains out of control. The dogma that DR-TB epidemics are fueled by unchecked rates of acquired resistance in inadequately treated or non-adherent individuals is no longer valid in most high DR-TB burden settings, where community transmission is now widespread. A large burden of DR-TB in Africa remains undiagnosed due to inadequate access to diagnostic tools that simultaneously detect tuberculosis and screen for resistance. Furthermore, acquisition of drug resistance to new and repurposed drugs, for which diagnostic solutions are not yet available, presents a major challenge for the implementation of novel, all-oral, shortened (6-9 months) treatment. Structural challenges including poverty, stigma, and social distress disrupt engagement in care, promote poor treatment outcomes, and reduce the quality of life for people with DR-TB. We reflect on the lessons learnt from the South African experience in implementing state-of-the-art advances in diagnostic solutions, deploying recent innovations in pharmacotherapeutic approaches for rapid cure, understanding local transmission dynamics and implementing interventions to curtail DR-TB transmission, and in mitigating the catastrophic socioeconomic costs of DR-TB. We also highlight globally relevant and locally responsive research priorities for achieving DR-TB control in South Africa.
    Language English
    Publishing date 2024-03-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2061641-7
    ISSN 1474-4457 ; 1473-3099
    ISSN (online) 1474-4457
    ISSN 1473-3099
    DOI 10.1016/S1473-3099(24)00144-0
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    Zs.A 5743: Show issues Location:
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  8. Article ; Online: Treatment of multidrug-resistant or rifampicin-resistant tuberculosis with an all-oral 9-month regimen containing linezolid or ethionamide in South Africa: A retrospective cohort study.

    Morgan, Hannah / Ndjeka, Norbert / Hasan, Tasnim / Gegia, Medea / Mirzayev, Fuad / Nguyen, Linh / Schumacher, Samuel / Schlub, Timothy E / Naidoo, Kogieleum / Fox, Greg J

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2024  

    Abstract: Background: In 2019, the South African tuberculosis program replaced ethionamide with linezolid as a part of an all-oral 9-month regimen. We evaluated treatment outcomes for patients assigned to regimens including linezolid in 2019 and ethionamide in ... ...

    Abstract Background: In 2019, the South African tuberculosis program replaced ethionamide with linezolid as a part of an all-oral 9-month regimen. We evaluated treatment outcomes for patients assigned to regimens including linezolid in 2019 and ethionamide in 2017.
    Method: This retrospective cohort study included patients treated for multi-drug resistant/rifampicin-resistant tuberculosis throughout South Africa between 1 Jan to 31 Dec 2017 and from 1 Jan to 31 Dec 2019. The cohort treated with a 9-month regimen containing ethionamide for four months, was compared with a cohort treated with a 9-month regimen containing linezolid for two months. The regimens were otherwise identical. Inverse probability weighting of propensity scores was used to adjust for potential confounding. A log-binomial regression model was used to estimate adjusted relative risk (aRR) comparing 24-month outcomes between cohorts including treatment success, death, loss to follow up, and treatment failure. Adverse event data were available for the linezolid cohort.
    Findings: 817 patients were included in the cohort receiving ethionamide and 4244 in the cohort receiving linezolid. No evidence for a difference was observed between linezolid and ethionamide regimens for treatment success (aRR = 0·96, 95%CI 0·91-1·01), death (aRR = 1·01, 95%CI 0·87-1·17) or treatment failure (aRR = 0·87, 95%CI 0·44-1·75). Loss to follow up was more common in the linezolid group, although estimates were imprecise (aRR = 1·22, 95%CI 0·99-1·50).
    Interpretation: No significant differences in treatment success and survival were observed with substitution of linezolid for ethionamide as a part of an all-oral 9-month regimen. Linezolid is an acceptable alternative to ethionamide in this shorter regimen for treatment of multi-drug resistant/rifampicin resistant tuberculosis.
    Language English
    Publishing date 2024-03-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciae145
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    Zs.MO 480: Show issues

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  9. Article ; Online: Diagnostics to support the scaling up of shorter, safer tuberculosis regimens.

    Branigan, David / Denkinger, Claudia M / Furin, Jennifer / Heitkamp, Petra / Deborggraeve, Stijn / van Gemert, Wayne / Herrera, Rosa / Kondratyuk, Sergiy / McKenna, Lindsay / Ndjeka, Norbert / Omar, Shaheed Vally / Pai, Madhukar

    The Lancet. Microbe

    2023  Volume 4, Issue 10, Page(s) e758–e760

    Language English
    Publishing date 2023-07-31
    Publishing country England
    Document type Journal Article
    ISSN 2666-5247
    ISSN (online) 2666-5247
    DOI 10.1016/S2666-5247(23)00217-3
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  10. Article ; Online: Global adoption of 6-month drug-resistant TB regimens: Projected uptake by 2026.

    Gupta, Aastha / Juneja, Sandeep / Babawale, Victor / Rustam Majidovich, Nurov / Ndjeka, Norbert / Thi Mai Nguyen, Phuong / Nargiza Nusratovna, Parpieva / Robert Omanito, David / Tiara Pakasi, Tiffany / Terleeva, Yana / Toktogonova, Atyrkul / Waheed, Yasir / Myint, Zaw / Yanlin, Zhao / Sahu, Suvanand

    PloS one

    2024  Volume 19, Issue 1, Page(s) e0296448

    Abstract: Background: The WHO has issued a call to action urging countries to accelerate the rollout of new WHO-recommended shorter all-oral treatment regimens for drug-resistant TB (DR-TB), which remains a public-health crisis. The all-oral, 6-month BPaL/M ... ...

    Abstract Background: The WHO has issued a call to action urging countries to accelerate the rollout of new WHO-recommended shorter all-oral treatment regimens for drug-resistant TB (DR-TB), which remains a public-health crisis. The all-oral, 6-month BPaL/M regimen comprises 3-4 drugs: pretomanid used in combination with bedaquiline and linezolid, with or without moxifloxacin. This regimen has been recommended by the WHO for use in DR-TB patients instead of ≥9-month (up to 24-month) regimens. This study aims to project this regimen's use, along with its components bedaquiline, pretomanid and linezolid, and other treatments for DR-TB globally through 2026. It is intended to guide global health stakeholders in planning and budgeting for DR-TB interventions. Projected usage could help estimate cost of the individual components of DR-TB regimens over time.
    Methods: Semi-structured interviews were conducted with national TB programme participants in key countries to gather intelligence on established plans and targets for use of various DR-TB treatment regimens from 2023 to 2026. These data informed development of projections for the global use of regimens and drugs.
    Results: Consistent global growth in the use of shorter regimens in DR-TB treatment was shown: BPaLM reaching 126,792 patients, BPaL reaching 43,716 patients, and the 9-11-month all-oral bedaquiline-based regimen reaching 13,119 patients by 2026. By 2026, the longer all-oral regimen is projected to be used by 19,262 patients, and individualised treatment regimens by 15,344 patients.
    Conclusion: The study shows BPaL/M will be used in majority of DR-TB patients by 2024, reaching 78% by 2026. However, national efforts to scale-up, case-finding, monitoring, drug-susceptibility testing, and implementation of new treatments will be essential for ensuring they are accessible to all eligible patients in the coming years and goals for ending TB are met. There is an urgent need to engage communities in capacity building and demand generation.
    MeSH term(s) Humans ; Linezolid ; Clinical Protocols ; Biological Transport ; Tuberculosis, Multidrug-Resistant/drug therapy
    Chemical Substances pretomanid ; Linezolid (ISQ9I6J12J)
    Language English
    Publishing date 2024-01-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0296448
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