title: The imminent threat of multidrug-resistant tuberculosis in Singapore.
abstract: The global emergence of multidrugresistant (MDR) tuberculosis (TB) and extensively drug-resistant (XDR)-TB threatens to derail the efforts of TB control programmes worldwide. From 2000 to 2010, 161 pulmonary MDR-TB cases (including six XDR-TB cases) were reported in Singapore, and of these, 80% occurred among the foreign-born, with an increasing trend seen after 2004. Among new pulmonary TB cases, the highest incidence of MDR-TB occurred among patients from Myanmar (8%), followed by Vietnam (4.4%) and China (2.3%), while among those previously treated, the highest incidence was found in patients from Vietnam (50%), followed by Indonesia (33%) and Bangladesh (33%). Although the proportion of Singapore-born pulmonary TB cases with MDR-TB has remained comparatively low (0.2% and 1.3% in new and previously treated cases, respectively), there is no room for complacency. Top priority must be accorded toward the proper treatment of drug-susceptible TB cases under strict programme conditions so as to prevent the development of MDR-TB in the first place.
authors.affiliation: TB Control Unit, Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore. cynthia_chee@ttsh.com.sg
authors.forename: Cynthia Bin-Eng
authors.initials: CB
authors.lastname: Chee
authors.forename: Kyi Win
authors.initials: KW
authors.lastname: Khin-Mar
authors.forename: Jeffery
authors.initials: J
authors.lastname: Cutter
authors.forename: Yee Tang
authors.initials: YT
authors.lastname: Wang
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D054242:Emigrants and Immigrants; D054908:Extensively Drug-Resistant Tuberculosis / Q000453:epidemiology; D006801:Humans; D009169:Mycobacterium tuberculosis; D012846:Singapore / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology / Q000635:transmission
chemical_list: D000995:Antitubercular Agents