title: Multidrug-resistant tuberculosis management in resource-limited settings.
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.
authors.affiliation: Stop TB Department, World Health Organization, Geneva, Switzerland. nathansone@who.int
authors.forename: Eva
authors.initials: E
authors.lastname: Nathanson
authors.forename: Catharina
authors.initials: C
authors.lastname: Lambregts-van Weezenbeek
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rich
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gupta
authors.forename: Jaime
authors.initials: J
authors.lastname: Bayona
authors.forename: Kai
authors.initials: K
authors.lastname: Blöndal
authors.forename: José A
authors.initials: JA
authors.lastname: Caminero
authors.forename: J Peter
authors.initials: JP
authors.lastname: Cegielski
authors.forename: Manfred
authors.initials: M
authors.lastname: Danilovits
authors.forename: Marcos A
authors.initials: MA
authors.lastname: Espinal
authors.forename: Vahur
authors.initials: V
authors.lastname: Hollo
authors.forename: Ernesto
authors.initials: E
authors.lastname: Jaramillo
authors.forename: Vaira
authors.initials: V
authors.lastname: Leimane
authors.forename: Carole D
authors.initials: CD
authors.lastname: Mitnick
authors.forename: Joia S
authors.initials: JS
authors.lastname: Mukherjee
authors.forename: Paul
authors.initials: P
authors.lastname: Nunn
authors.forename: Alexander
authors.initials: A
authors.lastname: Pasechnikov
authors.forename: Thelma
authors.initials: T
authors.lastname: Tupasi
authors.forename: Charles
authors.initials: C
authors.lastname: Wells
authors.forename: Mario C
authors.initials: MC
authors.lastname: Raviglione
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003140:Communicable Disease Control / Q000379:methods; D003906:Developing Countries; D004334:Drug Administration Schedule; D004957:Estonia / Q000453:epidemiology; D006078:Government Programs; D006801:Humans; D007844:Latvia / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D010679:Philippines / Q000453:epidemiology; D015397:Program Evaluation; D012426:Russia / Q000453:epidemiology; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D000995:Antitubercular Agents