%0 Journal Article
%T Efficacy of Bedaquiline in the Management of Multidrug-Resistant Tuberculosis in the Central African Republic
%A Boris Jolly Lokoti
%A Alain Farra
%A Alexandre Manirakiza
%A Herve Gando
%A Doriane Ouanibilo
%A Wilfrid Sylvain Nambei
%J Journal of Tuberculosis Research
%P 61-68
%@ 2329-8448
%D 2025
%I Scientific Research Publishing
%R 10.4236/jtr.2025.132006
%X Multidrug-resistant tuberculosis (MDR-TB) poses a major challenge in the Central African Republic (CAR), as the high incidence of tuberculosis and resistance rates to anti-tuberculosis drugs compromise efforts to manage MDR/RR-TB patients. This study evaluates the efficacy of bedaquiline, integrated into the short BPaLM regimen (Bedaquiline-Pretomanid-Linezolid-Moxifloxacin), in 68 patients with MDR-TB or pre-extensively drug-resistant (pre-XDR) TB. Strains from the National Reference Laboratory of Bangui underwent whole-genome sequencing and in silico resistance analysis. Among the participants (mean age: 32 years; 60.29% male), 82.35% had MDR-TB and 4.42% had pre-XDR TB. All strains were sensitive to bedaquiline, with no mutation detected in the atpC gene. Of the 59 patients treated, 57 (96.6%) successfully completed the 9-month protocol, confirmed by a negative culture at month 21. Two deaths, occurring before the start of treatment (due to a drug stockout), were not attributable to the treatment regimen. These results demonstrate exceptional efficacy of bedaquiline in a real-world setting, with a 100% therapeutic success rate among patients who received the treatment. The study underscores the importance of continuous access to medications and supports adopting the BPaLM regimen in CAR to improve MDR/RR-TB management. These findings support the integration of bedaquiline into national strategies, aligned with WHO objectives for tuberculosis elimination.
%K Multidrug-Resistant Tuberculosis
%K Bedaquiline
%K Central African Republic
%K Genomic Sequencing
%K BPaLM Regimen
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=143475