title: Multidrug-resistant TB in Zambia: review of national data from 2000 to 2011.
abstract: BACKGROUND
  Multidrug-resistant tuberculosis (MDR-TB) is posing a great threat to global TB control. The burden in Zambia is not well defined because routine surveillance data are scarce. We reviewed national MDR-TB data for the last decade to inform future public health policy with respect to MDR-TB in Zambia.
  
  
  METHODS
  Retrospective review of national surveillance of MDR-TB data, TB programme and laboratory reports between 2000 and 2011.
  
  
  RESULTS
  The total number of DSTs performed during this 11-year period was 2,038 and accounted for 2.6% (2,038/78,639) of all the retreatment cases notified. The total number of diagnosed MDR-TB cases for this period was 446, of which 56.3% (251/446) were male and 41.7% (186/446) female. Only one child was found to have MDR-TB. Poly-drug resistance accounted for 18.9% (172/911) of the DR-TB cases and 8.4% of the total DSTs. 8.8% (80/911) of the DR-TB cases showed either rifampicin mono- or poly-resistance other than MDR-TB. No XDR-TB was reported. There were no data available on DR-TB and HIV co-infection. Only 65 MDR-TB patients were notified and put on second-line treatment according to WHO guidelines.
  
  
  CONCLUSIONS
  Multidrug-resistant tuberculosis may be an emerging challenge in Zambia. There is a need to invest in improving the capacity of the TB programme to detect and manage MDR-TB.
authors.affiliation: Ministry of Health, Lusaka, Zambia; National TB and Leprosy Control Programme, Ministry of Health, Lusaka, Zambia; University of Zambia-University College London Medical School Research and Training Programme, Lusaka, Zambia; Center for Tropical Medicine and Travel Medicine, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Nathan
authors.initials: N
authors.lastname: Kapata
authors.forename: Pascalina
authors.initials: P
authors.lastname: Chanda-Kapata
authors.forename: Matthew
authors.initials: M
authors.lastname: Bates
authors.forename: Peter
authors.initials: P
authors.lastname: Mwaba
authors.forename: Frank
authors.initials: F
authors.lastname: Cobelens
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
mesh_terms: D000328:Adult; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D019468:Disease Management; D054908:Extensively Drug-Resistant Tuberculosis / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D015994:Incidence; D008297:Male; D011159:Population Surveillance; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use; D012737:Sex Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology; D015024:Zambia / Q000453:epidemiology
chemical_list: D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D012293:Rifampin
keywords: Zambia; diagnosis; multidrug-resistant tuberculosis; retreatments; surveillance; tuberculosis