title: Countrywide audit of multidrug-resistant tuberculosis and treatment outcomes in Mongolia.
abstract: METHODS
  Eighteen treatment units for multidrug-resistant tuberculosis (MDR-TB) in Mongolia.
  
  
  OBJECTIVE
  To determine the total number of MDR-TB cases detected, their resistance patterns, the proportion and characteristics of cases starting treatment, the delay between diagnosis and treatment initiation, and the relation between treatment outcomes and drug resistance.
  
  
  METHODS
  Retrospective cohort study using routine programme data.
  
  
  RESULTS
  Of 268 MDR-TB cases detected, 168 (63%) were resistant to HRES, 59 (22%) to HRS, 34 (13%) to HR and 7 (3%) to HRE. Of the 268 MDR-TB patients, 139 (52%) started treatment: 69 (50%) were secondary and/or university students, 35 (25%) were unemployed, 24 (17%) were currently employed and 14 (8%) retired, disabled or status was unrecorded. The median time from MDR-TB diagnosis to treatment initiation was 137 days (IQR 43-218). The treatment success rate was 69%; 9% failed treatment, which may indicate extensively drug-resistant TB (XDR-TB) or pre-XDR-TB.
  
  
  CONCLUSIONS
  Close to seven in 10 patients in Mongolia had a successful treatment outcome, which is encouraging. Specific problems included the high proportion of students, about half of all diagnosed patients accessed treatment and there was an unacceptable delay of 4 months to treatment. These issues need to be addressed.
authors.affiliation: Global Fund-supported Project on AIDS and TB, Ministry of Health, Ulaanbaatar, Mongolia.
authors.forename: S
authors.initials: S
authors.lastname: Ganzaya
authors.affiliation: TB Coalition, Ulaanbaatar, Mongolia.
authors.forename: N
authors.initials: N
authors.lastname: Naranbat
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: K
authors.initials: K
authors.lastname: Bissell
authors.affiliation: Médecins Sans Frontières, Brussels Operational Centre, Luxembourg.
authors.forename: R
authors.initials: R
authors.lastname: Zachariah
keywords: MDR-TB; Mongolia; drug-resistant pattern