1. Multidrug-resistant tuberculosis management in resource-limited settings.
- Author
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Nathanson E, Lambregts-van Weezenbeek C, Rich ML, Gupta R, Bayona J, Blöndal K, Caminero JA, Cegielski JP, Danilovits M, Espinal MA, Hollo V, Jaramillo E, Leimane V, Mitnick CD, Mukherjee JS, Nunn P, Pasechnikov A, Tupasi T, Wells C, and Raviglione MC
- Subjects
- Communicable Disease Control methods, Drug Administration Schedule, Estonia epidemiology, Humans, Latvia epidemiology, Peru epidemiology, Philippines epidemiology, Program Evaluation, Russia epidemiology, Treatment Outcome, Tuberculosis, Multidrug-Resistant microbiology, Antitubercular Agents administration & dosage, Antitubercular Agents therapeutic use, Developing Countries, Government Programs, Tuberculosis, Multidrug-Resistant drug therapy, Tuberculosis, Multidrug-Resistant prevention & control
- 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.
- Published
- 2006
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