National anti-tuberculosis drug resistance survey, 2002, in Myanmar.
METHODS
Thirty townships of Myanmar.


OBJECTIVE
To determine the proportions of drug-resistant tuberculosis (TB) in new and previously treated pulmonary tuberculosis (PTB) cases in Myanmar.


METHODS
A cross-sectional study. Drug susceptibility was tested by the proportion method at the National Tuberculosis Reference Laboratory, Yangon.


RESULTS
Of 874 TB patients included from 30 sites, 849 isolates obtained from individual patients (733 from new cases and 116 from previously treated cases) were tested for susceptibility to four primary anti-tuberculosis drugs. Of 733 isolates tested from new TB patients, 10% were resistant to any one of the anti-tuberculosis drugs, 6.5% to isoniazid (INH), 4.6% to rifampicin (RMP) and 4.0% were multidrug-resistant (MDR). Of the 116 previously treated patients, 30.2% were resistant to any one of the drugs, 26.7% to INH, 15.5% to RMP and 15.5% were MDR. Previous anti-tuberculosis treatment of more than 1 month was strongly associated with the development of MDR-TB (adjusted OR 4.8, 95% CI 2.5-9.1).


CONCLUSIONS
The first national drug resistance survey in Myanmar revealed 4% and 15.5% MDR-TB among new and retreatment cases, respectively. Previous antituberculosis treatment was an important risk factor for MDR-TB. Continuous monitoring of drug resistance trends is needed
Ti
T
T
National Tuberculosis Programme, Yangon General Hospital Extension Compound, Myanmar. titi@mptmail.net.mm
Lwin
T
T
Mar
T T
TT
Maung
W
W
Noe
P
P
Htun
A
A
Kluge
H H
HH
Wright
A
A
Aziz
M A
MA
Paramasivan
C N
CN
D000293:Adolescent; D000328:Adult; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D006306:Health Surveys; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D002052:Myanmar / Q000453:epidemiology; D012293:Rifampin / Q000627:therapeutic use; D012307:Risk Factors; D013307:Streptomycin / Q000627:therapeutic use; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology
D000904:Antibiotics, Antitubercular; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin