Treatment outcome of multidrug-resistant tuberculosis among Vietnamese immigrants.
OBJECTIVE
To review the outcome for MDR-TB treatment among potential migrants from Vietnam.


METHODS
All cases of documented MDR-TB treated by the International Organization of Migration (IOM) in Vietnam from 1989 to 2000 were reviewed.


METHODS
MDR-TB was defined as isoniazid- and rifampicin-resistant Mycobacterium tuberculosis. All cases of TB treated by the IOM and recorded in the computerised database were reviewed to identify MDR-TB cases. Demographics, chest radiograph results, drug resistance, drug use and dosage, duration of treatment, and outcome were analysed.


RESULTS
Forty-four cases of MDR-TB were identified. Treatment consisted of ambulatory directly observed treatment with an 8-drug protocol: isoniazid, rifampicin, pyrazinamide, ethambutol, capreomycin, ethionamide, ofloxacin and cycloserine. This initial protocol was modified due to drug availability or drug intolerance. Patients were treated with a median of 8 drugs (range 6-12). Mean duration of treatment for MDR-TB was 23.0 (SD+/-11.4) months. Thirty-eight (86%) patients were cured and emigrated, one failed treatment (2%), three were lost to follow-up (7%) and two died (4%).


CONCLUSIONS
Treatment for MDR-TB provided by the IOM was effective in preparing a low-income population for migration.
Ward
H A
HA
Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. heather.ward@saskatoonhealthregion.ca
Marciniuk
D D
DD
Hoeppner
V H
VH
Jones
W
W
D002207:Capreomycin / Q000008:administration & dosage; D003523:Cycloserine / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004641:Emigration and Immigration; D004977:Ethambutol / Q000008:administration & dosage; D005000:Ethionamide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage; D011718:Pyrazinamide / Q000008:administration & dosage; D012293:Rifampin / Q000008:administration & dosage; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D014744:Vietnam / Q000208:ethnology
D002207:Capreomycin; D011718:Pyrazinamide; D004977:Ethambutol; D003523:Cycloserine; D015242:Ofloxacin; D005000:Ethionamide; D007538:Isoniazid; D012293:Rifampin