title: Drug-resistant tuberculosis in the WHO Western Pacific Region.
abstract: OBJECTIVE
  To review the latest information about tuberculosis (TB) drug resistance and programmatic management of drug-resistant TB in the Western Pacific Region of the World Health Organization (WHO).
  
  
  METHODS
  We analysed routine data reported by countries to WHO from 2007 to 2013, focusing on data from the following: surveillance and surveys of drug resistance, management of drug-resistant TB and financing related to multidrug-resistant TB (MDR-TB) management.
  
  
  RESULTS
  In the Western Pacific Region, 4% (95% confidence interval [CI]: 3-6) of new and 22% (95% CI: 18-26) of previously treated TB cases were estimated to have MDR-TB; this means that in 2013, there were an estimated 71,000 (95% CI: 47,000-94,000) MDR-TB cases among notified pulmonary TB cases in this Region. The coverage of drug susceptibility testing (DST) among new and previously treated TB cases was 3% and 20%, respectively. In 2013, 11,153 cases were notified--16% of the estimated MDR-TB cases. Among the notified cases, 6926 or 62% were enrolled in treatment. Among all enrolled MDR-TB cases, 34% had second-line DST and of these, 13% were resistant to fluoroquinolones (FQ) and/or second-line injectable agents. The 2011 cohort of MDR-TB showed a 52% treatment success. Over the last five years, case notification and enrolment have increased more than five times, but the gap between notification and enrolment widened.
  
  
  CONCLUSIONS
  The increasing trend in detection and enrolment of MDR-TB cases demonstrates readiness to scale up programmatic management of drug-resistant TB at the country level. However, considerable challenges remain.
authors: Stop TB and Leprosy Elimination, Division of Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Manila, Philippines .
authors: Tauhid
authors: T
authors: Islam
authors: Stop TB and Leprosy Elimination, Division of Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Manila, Philippines .
authors: Tom
authors: T
authors: Hiatt
authors: Stop TB and Leprosy Elimination, Division of Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Manila, Philippines .
authors: Cornelia
authors: C
authors: Hennig
authors: Stop TB and Leprosy Elimination, Division of Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Manila, Philippines .
authors: Nobuyuki
authors: N
authors: Nishikiori
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D001208:Asia / Q000453:epidemiology; D044362:Australasia / Q000453:epidemiology; D017281:Cost of Illness; D019468:Disease Management; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D010139:Pacific Islands / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology*; D014944:World Health Organization
chemical_list: D000995:Antitubercular Agents