title: A reduction in anti-tuberculosis drug resistance after the implementation of the national "STOP TB" program in central Taiwan, 2003-2007.
abstract: The aim of this study was to determine the performance of the national "STOP TB" program in central Taiwan during 2003-2007 by examining trends in the combined drug resistance to first-line anti-tuberculosis (TB) drugs among clinical Mycobacterium tuberculosis isolates. Using 4,819 clinical M. tuberculosis isolates obtained from two mycobacteriology referral laboratories, the resistance to drugs was measured and analyzed along with the treatment outcomes in notified TB patients. The proportion of isolates showing total resistance and multidrug-resistant tuberculosis (MDR-TB) isolates were 17.7% and 3.67%, respectively. More number of MDR-TB isolates showed high-level resistance to isoniazid (84.18%) and streptomycin (SM) (30.51%); low-level resistance to ethambutol (EMB) (61.58%), SM (41.81%), and pyrazinamide (66.1%); and resistance to ofloxacin (30.4%). However, fewer isolates showed high-level resistance to EMB (19.77%), levofloxacin (17.9%), moxifloxacin (19.6%), kanamycin (8.9%), amikacin (8.9%), and capreomycin (8.9%). Of these MDR-TB isolates, 7.1% were extensively drug-resistant. Trends in combined drug resistance to all the first-line anti-TB drugs and the incidence of MDR-TB were stable during the 2 years (2003-2004) before the implementation of the national "STOP TB" program. After the "STOP TB" program, there were significant declines in the incidence of MDR-TB during 2005-2007 in central Taiwan as well as improved TB-treatment outcomes. Thus, the national "STOP TB" program had a significant positive impact on TB control in central Taiwan.
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: Wei-Chang
authors.initials: WC
authors.lastname: Huang
authors.forename: Chao-Hsien
authors.initials: CH
authors.lastname: Chen
authors.forename: Chen-Cheng
authors.initials: CC
authors.lastname: Huang
authors.forename: Kun-Ming
authors.initials: KM
authors.lastname: Wu
authors.forename: Chien-Shun
authors.initials: CS
authors.lastname: Chiou
authors.forename: Chen-Fu
authors.initials: CF
authors.lastname: Lin
authors.forename: Jiann-Hwa
authors.initials: JH
authors.lastname: Chen
authors.forename: Gwan-Han
authors.initials: GH
authors.lastname: Shen
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003140:Communicable Disease Control / Q000379:methods; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006291:Health Policy; D006801:Humans; D015994:Incidence; D008297:Male; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents