Emerging Infectious Diseases (Sep 2006)

Multidrug-resistant Tuberculosis Management in Resource-limited Settings

  • Eva Nathanson,
  • Catharina Lambregts-van Weezenbeek,
  • Michael 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 E. Tupasi,
  • Charles Wells,
  • Mario C. Raviglione

DOI
https://doi.org/10.3201/eid1209.051618
Journal volume & issue
Vol. 12, no. 9
pp. 1389 – 1397

Abstract

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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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