title: Prescription patterns and treatment outcomes of MDR-TB patients treated within and outside the National Tuberculosis Programme in Pham Ngoc Thach hospital, Viet Nam.
abstract: OBJECTIVE
  To describe and analyse the prescription patterns and treatment outcomes of MDR-TB patients managed within Green Light Committee (GLC) and outside (non-GLC) the National TB programme in Viet Nam.
  
  
  METHODS
  Retrospective cohort study with two elements: (i) in-depth interviews and focus group discussions with clinical doctors, hospital pharmacists, and the non-GLC patients with MDR-TB; (ii) review of treatment cards and patients' charts of all GLC and non-GLC patients with MDR-TB put on treatment during 2010.
  
  
  RESULTS
  Of 282 patients with MDR-TB, comprising 79 (28%) GLC patients MDR-TB and 203 (72%) non-GLC patients with MDR-TB, were enrolled in the study. Treatment delay was significantly higher in the GLC group (12.8 days) than the non-GLC group (2.3 days), (P = 0.004). The success rate was significantly better in GLC patients (84.8%) than in non-GLC patients (53.7%) (P < 0.001). The default rate was significantly higher in non-GLC patients than in GLC patients (25.6% vs. 6.3%), (P < 0.001). The risk of unsuccessful outcome was higher in non-GLC patients (Hazard ratio = 4.6, 95% CI: 1.8-11.8).
  
  
  CONCLUSIONS
  The treatment outcomes of patients with MDR-TB in the GLC group were significantly better than in the non-GLC group. Reasons for the high default rate in non-GLC patients with MDR-TB must be further investigated.
authors.affiliation: National Tuberculosis Programme Vietnam, Hanoi, Viet Nam; Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: Nguyen B
authors.initials: NB
authors.lastname: Hoa
authors.forename: Pham H
authors.initials: PH
authors.lastname: Khanh
authors.forename: Nguyen V
authors.initials: NV
authors.lastname: Chinh
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: Hennig
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006297:Health Services Accessibility; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D015397:Program Evaluation; D012189:Retrospective Studies; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000382:microbiology; D014744:Vietnam; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: GLC; Green Light Committee; TB-MDR; Tuberculosis multidrogoresistente; multidrug-resistant TB; private sector; resultado del tratamiento; résultats du traitement; secteur privé; sector privado; treatment outcome; tuberculose multirésistante