Evidence of successful management of multidrug-resistant tuberculosis (MDRTB) is mainly generated from referral hospitals in high-income countries. We evaluate the management of MDRTB in 5 resource-limited countries: Estonia, Latvia, Peru, the Philippines, and the Russian Federation. All projects were approved by the Green Light Committee for access to quality-assured second-line drugs provided at reduced price for MDRTB management. Of 1,047 MDRTB patients evaluated, 119 (11%) were new, and 928 (89%) had received treatment previously. More than 50% of previously treated patients had received both first- and second-line drugs, and 65% of all patients had infections that were resistant to both first- and second-line drugs. Treatment was successful in 70% of all patients, but success rate was higher among new (77%) than among previously treated patients (69%). In resource-limited settings, treatment of MDRTB provided through, or in collaboration with, national TB programs can yield results similar to those from wealthier settings.
Multidrug-resistant tuberculosis management in resource-limited settings / E. Nathanson, C.L. Weezenbeek, M.L. Rich, R. Gupta, J. Bayona, K. Blöndal, J.A. Caminero, J.P. Cegielski, M. Danilovits, M.A. Espinal, V. Hollo, E. Jaramillo, V. Leimane, C.D. Mitnick, J.S. Mukherjee, P. Nunn, A. Pasechnikov, T. Tupasi, C. Wells, M.C. Raviglione. - In: EMERGING INFECTIOUS DISEASES. - ISSN 1080-6040. - 12:9(2006), pp. 1389-1397. [10.3201/eid1209.051618]
Multidrug-resistant tuberculosis management in resource-limited settings
M.C. Raviglione
2006
Abstract
Evidence of successful management of multidrug-resistant tuberculosis (MDRTB) is mainly generated from referral hospitals in high-income countries. We evaluate the management of MDRTB in 5 resource-limited countries: Estonia, Latvia, Peru, the Philippines, and the Russian Federation. All projects were approved by the Green Light Committee for access to quality-assured second-line drugs provided at reduced price for MDRTB management. Of 1,047 MDRTB patients evaluated, 119 (11%) were new, and 928 (89%) had received treatment previously. More than 50% of previously treated patients had received both first- and second-line drugs, and 65% of all patients had infections that were resistant to both first- and second-line drugs. Treatment was successful in 70% of all patients, but success rate was higher among new (77%) than among previously treated patients (69%). In resource-limited settings, treatment of MDRTB provided through, or in collaboration with, national TB programs can yield results similar to those from wealthier settings.
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