Prescription patterns and treatment outcomes of MDR-TB patients treated within and outside the National Tuberculosis Programme in Pham Ngoc Thach hospital, Viet Nam

Abstract

Objective: To describe and analyse the prescription patterns and treatment outcomes of MDR-TB patients managed within Green Light Committee (GLC) and outside (non-GLC) the National TB programme in Viet Nam.

Methods: Retrospective cohort study with two elements: (i) in-depth interviews and focus group discussions with clinical doctors, hospital pharmacists, and the non-GLC patients with MDR-TB; (ii) review of treatment cards and patients' charts of all GLC and non-GLC patients with MDR-TB put on treatment during 2010.

Results: Of 282 patients with MDR-TB, comprising 79 (28%) GLC patients MDR-TB and 203 (72%) non-GLC patients with MDR-TB, were enrolled in the study. Treatment delay was significantly higher in the GLC group (12.8 days) than the non-GLC group (2.3 days), (P = 0.004). The success rate was significantly better in GLC patients (84.8%) than in non-GLC patients (53.7%) (P < 0.001). The default rate was significantly higher in non-GLC patients than in GLC patients (25.6% vs. 6.3%), (P < 0.001). The risk of unsuccessful outcome was higher in non-GLC patients (Hazard ratio = 4.6, 95% CI: 1.8-11.8).

Conclusions: The treatment outcomes of patients with MDR-TB in the GLC group were significantly better than in the non-GLC group. Reasons for the high default rate in non-GLC patients with MDR-TB must be further investigated.

Keywords: GLC; Green Light Committee; TB-MDR; Tuberculosis multidrogoresistente; multidrug-resistant TB; private sector; resultado del tratamiento; résultats du traitement; secteur privé; sector privado; treatment outcome; tuberculose multirésistante.