Publications by authors named "P Migambi"
Safety of high-dose amikacin in the first week of all-oral rifampicin-resistant tuberculosis treatment for the prevention of acquired resistance (STAKE): protocol for a single-arm clinical trial.
BMJ Open
July 2024
Introduction: An effective rifampicin-resistant tuberculosis (RR-TB) treatment regimen should include prevention of resistance amplification. While bedaquiline (BDQ) has been recommended in all-oral RR-TB treatment regimen since 2019, resistance is rising at alarming rates. This may be due to BDQ's delayed bactericidal effect, which increases the risk of selecting for resistance to fluoroquinolones and/or BDQ in the first week of treatment when the bacterial load is highest.
View Article and Find Full Text PDFBackground: Non-conversion of sputum smear prolongs the infectivity of pulmonary tuberculosis patients and has been associated with unfavorable tuberculosis (TB) treatment outcomes. Nevertheless, there is a limited evidence on predictors of sputum smear non-conversion among smear-positive PTB (SPPTB) patients in Rwanda. Therefore, this study aimed to determine the factors associated with sputum smear non-conversion after two months of treatment among SPPTB patients in Rwanda.
View Article and Find Full Text PDFBackground: Since the roll-out of the Xpert MTB/RIF assay, continuous surveillance can provide an estimate of rifampicin-resistant TB (RR-TB) prevalence, provided high drug susceptibility testing (DST) coverage is achieved. We use national data from Rwanda to describe rifampicin DST coverage, estimate the prevalence of RR-TB and assess its predictors.
Methods: Routinely collected DST data were entered into an electronic TB case-based surveillance system.
Article Synopsis
- Multidrug-resistant tuberculosis (MDR-TB), identified by rifampicin resistance (RR), poses significant challenges in managing TB in Rwanda, requiring investigation into its transmission dynamics over 27 years.
- The study involved analyzing the whole genome sequences of RR-TB isolates from three periods: before MDR-TB program management (1991-2005), during early program management (2006-2013), and during a more consolidated phase (2014-2018) when rifampicin drug-susceptibility testing was expanded.
- The results identified 13 transmission clusters among RR-TB isolates, with a dominant clone named "Rwanda Rifampicin-Resistant clone" (R3clone) being responsible for 69.
Tuberculosis (TB), including multidrug-resistant (MDR; i.e., resistant to at least rifampicin and isoniazid)/rifampicin-resistant (MDR/RR) TB, is the most important opportunistic infection among people living with HIV (PLHIV).
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