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Western Pac Surveill Response J. 2014 Dec 18;5(4):34-46. doi: 10.5365/WPSAR.2014.5.4.007. eCollection 2014 Oct-Dec.

Drug-resistant tuberculosis in the WHO Western Pacific Region.

Author information

1
Stop TB and Leprosy Elimination, Division of Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Manila, Philippines .

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.

DISCUSSION:

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.

PMID:
25685604
PMCID:
PMC4318977
DOI:
10.5365/WPSAR.2014.5.4.007
[Indexed for MEDLINE]
Free PMC Article

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