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. 2006 Sep;12(9):1389-97.
doi: 10.3201/eid1209.051618.

Multidrug-resistant tuberculosis management in resource-limited settings

Eva Nathanson  1 , Catharina Lambregts-van Weezenbeek, Michael L Rich, Rajesh Gupta, Jaime Bayona, Kai Blöndal, José A Caminero, J Peter Cegielski, Manfred Danilovits, Marcos A Espinal, Vahur Hollo, Ernesto Jaramillo, Vaira Leimane, Carole D Mitnick, Joia S Mukherjee, Paul Nunn, Alexander Pasechnikov, Thelma Tupasi, Charles Wells, Mario C Raviglione
Affiliations

Multidrug-resistant tuberculosis management in resource-limited settings

Eva Nathanson et al. Emerg Infect Dis. 2006 Sep.

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 1047 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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Figures

Figure 1
Figure 1
Treatment outcomes of multidrug-resistant tuberculosis patients in Estonia (46 patients), Latvia (245 patients), Lima (508 patients), Manila (105 patients), and Tomsk (143 patients).
Figure 2
Figure 2
Proportion of multidrug-resistant tuberculosis patients in the 5 sites previously treated with first-line drugs only or with first- and second-line drugs.
See this image and copyright information in PMC

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