Category Archives: Tuberculosis

Systematic review on treatment cost of multidrug-resistant tuberculosis

J Pharm Pharmacogn Res 6(2): 117-125, 2018.

Review | Revisión

An updated literature review concerning the treatment cost of multidrug-resistant tuberculosis

[Revisión actualizada sobre el costo del tratamiento de la tuberculosis multi-resistente a los fármacos]

Quang Vinh Tran1, Phuong Hong Le1, Nhi Hoang Yen Ngo2, Nam Xuan Vo3, Trung Quang Vo1*

1Department of Pharmacy Administration, Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam.
2Faculty of Pharmacy, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
3Department of Pharmacy, Division of Social and Administrative Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand.



Context: According to a report by the World Health Organization (WHO), there were 1.4 million deaths worldwide in 2015 from tuberculosis (TB), with 3.9% being new cases and 21% being previously treated cases of multidrug-resistant tuberculosis (MDR-TB).

Aims: To review the literature concerning the costing analysis situation of MDR-TB treatment.

Methods: The study was conducted as a systematic review, with a modified checklist being used as the vital instrument. A search was performed of three databases (PubMed, Cochrane, and Scopus) using the terms (cost OR economic, socioeconomic, expenditure, burden, fee, charge, budget impact) AND (resistance OR multidrug resistance, MDR) AND (tuberculosis OR TB, Mycobacterium tuberculosis) in order to identify relevant articles published from 2006 to the present.

Results: A total of 1238 abstracts were identified, and 12 papers were ultimately included in the study. The quantity of the published articles was found to increase during in the period 2008 to 2016. Almost all the studies were based on patients’ and healthcare systems’ perceptions. The main data sources used were medical establishments and the reports of various relevant organizations. Primary data were used twice as much as secondary data. All the costing types, including direct costs and indirect costs, were mentioned, albeit not with the same frequency.

Conclusions: Africa owns one-third of the articles included. Further, it was found that MDR-TB should be treated using ambulatory care rather than hospital-based models. Future research studies should focus on Asia, where drug resistance has proved to be a challenging issue.

Keywords: cost; literature review; multi-drug resistant tuberculosis; systematic review; tuberculosis.


Contexto: El informe mundial sobre la tuberculosis, presentado por la Organización Mundial de la Salud (OMS) en 2016, muestra que en 2015 hubo 1,4 millones de muertes por tuberculosis, 3,9% de nuevos casos y 21% de casos tratados con tuberculosis multirresistente.

Objetivos: Revisar la literatura científica concerniente al análisis del costo del tratamiento de la tuberculosis multirresistente a fármacos.

Métodos: Este estudio se realizó como una revisión sistemática utilizando una lista de comprobación modificada como un instrumento vital. Una búsqueda en tres bases de datos (PubMed, Cochrane y Scopus) con los términos de (cost OR economic, socioeconomic, expenditure, burden, fee, charge, budget impact) AND (resistance OR multidrug resistance, MDR) AND (tuberculosis OR TB, Mycobacterium tuberculosis) se utilizó para abordar una serie de artículos publicados desde 2006 hasta la actualidad.

Resultados: Se identificaron un total de 1.238 resúmenes y se incluyeron 12 artículos en este estudio. La cantidad de artículos publicados aumentó en el período 2008-2016. La mayoría de los estudios se basaron en la percepción del paciente y del sistema de salud. La fuente de datos utilizada fue principalmente del establecimiento médico y los informes de las organizaciones. Los datos primarios se utilizaron dos veces más que los datos secundarios. Todos los tipos de costos, costos directos e indirectos, fueron mencionados, pero no en la misma frecuencia.

Conclusiones: África posee un tercio de los artículos incluidos. La TB-MDR debe ser tratada con atención ambulatoria en lugar de modelos basados en hospitales. Las investigaciones futuras deberían centrarse en Asia, donde la resistencia a los medicamentos ha sido un tema desafiable.

Palabras Clave: costo; revisión de literatura; revisión sistemática; tuberculosis; tuberculosis multirresistente.

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Citation Format: Tran QV, Le PH, Ngo NHY, Vo NX, Vo TQ (2018) An updated literature review concerning the treatment cost of multidrug-resistant tuberculosis. J Pharm Pharmacogn Res 6(2): 117–125.

© 2018 Journal of Pharmacy & Pharmacognosy Research (JPPRes)


J Pharm Pharmacogn Res 2(Suppl. 1): S9, 2014

Special supplement with the abstract book of LATINFARMA 2013



Acosta A1, Kadir R2, Ahmad F2, Puig A1, Borrero R1, Garcia MA1, Rodriguez L1, Camacho F1, Reyes F1, Aguilar A1, Otero O1, Rubio P1, Marron R1, Tirado Y1, Reyes F1, Alvarez N1, Infante JF1, Fernandez S1, Zayas C1, Lanio ME3, Acevedo R1, Mohd Nor N2, Perez Quiñoy JL1, Sarmiento ME.1

1Instituto Finlay, La Habana, Cuba. E-mail:
2Universiti Sains Malaysia, Malaysia.
3Faculty of Biology , University of Havana, Cuba.

Tuberculosis remains as one of the main causes of morbidity and mortality due to infectious diseases. The current situation of the disease is characterized by an elevated morbidity and mortality, the low sensitivity of the diagnostic methods, the relative low therapeutic coverage, the growing appearance of multidrug resistant strains and the low efficacy of BCG in the prevention of adult pulmonary tuberculosis and the transmission of the disease. Taking into consideration these antecedents, the development of new prophylactic, diagnostic and therapeutic strategies are of the maximal priority internationally. Here we present our results in two main areas: The study of role of specific antibodies in the protection against mycobacteria, where different formulations of antibodies were evaluated in models of tuberculosis in mice. The administration of monoclonal IgA antibodies against Hspx antigen of M. tuberculosis by the mucosal route demonstrated a protective effect. M. tuberculosis preincubated with the same antibody decreased its infective capacity. In order to explore the potential for protection of human antibodies in the same model, human IgG formulations administered by the intranasal route protects mice from infection. The same effect was obtained when M. tuberculosis was administered to mice after preincubation with the human antibody formulation. Secretory human IgA purified from colostrums showed similar behavior than the previous formulations when evaluated in the same animal model. In another strategy, using the phage display technology, ligands specific for M. tuberculosis infected cells where developed. The results obtained with the different antibody formulations demonstrated the protective capacity of the specific antibody response against M. tuberculosis and support the application of these findings to the development of new vaccines and therapeutic tools against tuberculosis. Another area of interest is the evaluation of proteoliposomes and liposomes obtained from non pathogenic mycobacteria which where immunogenic and protective in mice.


J Pharm Pharmacogn Res 2(Suppl. 1): S79, 2014

Special supplement with the abstract book of LATINFARMA 2013



Bercovier H.

Department of Microbiology and Molecular Genetics, The Faculty of Medicine, Hebrew University of Jerusalem, Israel.

Tuberculosis (TB) was highly active much before the Industrial Revolution as proven by the documented presence of Mycobacterium tuberculosis in a North American Bison, 20.000 years ago, in Egyptian mommies, in human skeletons dating from the Middle-Age and up to the 17th Century in Western Europe. By the study of ancient DNA, we can retrace in Western Europe the emergence of TB that seems to reach its peak in the 18th Century and has declined since, especially in the 20th Century. In the late Middle age, the end of the epidemics of Leprosy could already indicate the importance of the diffusion of TB in the population; TB indeed may have conferred cross protection as it has been shown for BCG. Study of ancient DNA in skeletons originating from well characterized cemeteries showed that close to 25% of the population was infected by M. tuberculosis at the end of the Middle Age. In addition, the social impact of TB was such that from the13th to the 18th Century French and English Queens and Kings inherited the divine royal touch that cured Scrofula (TB lymphadenitis). In the 17th Century, in the British registries, 20% of the recorded deaths were due to Consumption or Phthisis. In the 18th Century, in the city of Bristol between 1790 and 1796 close to 50% of the recorded death were due Tuberculosis. This percentage drops to 25% at the beginning of the 19th Century (the peak of the Industrial Revolution) and to 14% at the end of the19th Century. TB mortality decreased by half in adults in England between 1851 and 1890 indicating the beginning of the end of the epidemics. It seems that the burst of the epidemics of TB was linked in Europe more with the development of commercial exchanges on a large scale and the development of cities and workshops rather than with the Industrial Revolution. The food alimentary situation and the movement of population seem to have been additive factors for that burst. This scenario could help us to predict what may happen in developing countries and what must be done to prevent a new burst of Tuberculosis.