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Multidrug-Resistant Tuberculosis Management in Resource-Limited Settings

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2006

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Centers for Disease Control and Prevention
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Nathanson, Eva, Catharina Lambregts-van Weezenbeek, Michael L. Rich, Rajesh Gupta, Jaime Bayona, Kai Blöndal, José A. Caminero, et al. 2006. Multidrug-resistant tuberculosis management in resource-limited settings. Emerging Infectious Diseases 12(9): 1389-1397.

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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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