Drug-resistant tuberculosis in Cuba. Results of the three global projects.
METHODS
The spread of multidrug-resistant tuberculosis (MDR TB) in the world remains a major public health problem. Surveillance of anti-TB drug resistance is therefore an essential tool for monitoring the effectiveness of TB control program and, through policy development, for improving national and global TB control.


OBJECTIVE
To determine the prevalence of anti-TB drug resistance in Cuba during the execution of the three global projects.


METHODS
Drug-resistance was determined using the proportion method in 1528 Mycobacterium tuberculosis strains to first line anti-TB drugs.


RESULTS
Resistance in new cases was 8.3%, 4.6% and 5.0%; MDR was 0.7%, 0% and 0.3% in the first (1997), second (2000) and third (2004) global projects, respectively. In new cases, none showed resistance to the four drugs. There were among previously treated cases statistically significant decreases in the prevalence of resistance to at least one drug when comparing the results obtained in the three global projects.


CONCLUSIONS
The contributed data through Cuba demonstrated that our country is relatively free of MDR strains, reflecting the good National Control Program and the possibility of TB elimination in Cuba.
Montoro
Ernesto
E
PAHO/WHO Collaborating Center on Tuberculosis and Mycobacteria, Institute of Tropical Medicine Pedro Kourí, Havana, Cuba. emontoro@ipk.sld.cu
Lemus
Dihadenys
D
Echemendía
Miguel
M
Armas
Luisa
L
González-Ochoa
Edilberto
E
Llanes
María J
MJ
Valdivia
José A
JA
D000995:Antitubercular Agents / Q000494:pharmacology; D003462:Cuba / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D011159:Population Surveillance; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
D000995:Antitubercular Agents