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Ci Ji Yi Xue Za Zhi. 2019 Jan-Mar;31(1):35-39. doi: 10.4103/tcmj.tcmj_18_18.

Treatment outcomes for multidrug-resistant tuberculosis in Eastern Taiwan.

Author information

1
Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
2
Department of Internal Medicine, Mennonite Christian Hospital, Hualien, Taiwan.
3
International Union Against Tuberculosis and Lung Disease, Paris, France.
4
Department of Internal Medicine, Wan Fang Hospital and School of Medicine, Taipei Medical University, Taipei, Taiwan.
5
Department of Internal Medicine, Mackay Memorial Hospital Taitung Branch, Taitung, Taiwan.
6
Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
7
Division of General Internal Medicine, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan.

Abstract

Objectives:

The objective of this study is to evaluate the treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) under special programmatic management in Eastern Taiwan over the past 10 years.

Materials and Methods:

All newly diagnosed MDR-TB patients and MDR-TB patients enrolled previously with persistent positive cultures were included in this study, from May 2007 to April 2017, in Eastern Taiwan. A panel of pulmonologists designed the initial MDR-TB regimens. Subsequently, regimens were adjusted according to drug susceptibility test results for second-line drugs. Mobile teams were organized for treatment support, and several measures were adapted to safeguard effective treatment support.

Results:

A total of 178 patients with bacteriological confirmed pulmonary MDR-TB were identified, of whom 167 had treatment outcomes when the study was conducted. Of these 167 patients, 120 (71.9%) were cured, 11 (6.5%) completed therapy (78.4% had successful treatment), 25 (15.0%) died, 9 (5.4%) had treatment failure, none were transferred out, and 2 (1.2%) were lost to follow-up. Surgery was performed on 8 (4.8%).

Conclusions:

This is an analysis of the treatment outcomes after adopting the Directly Observed Treatment, Short-course Plus program to treat MDR-TB patients in Eastern Taiwan. We had a low proportion of loss-to-follow-up, resulting in a high treatment success rate. This program serves as an effective model in providing quality care to patients with MDR-TB.

KEYWORDS:

Directly observed treatment; Eastern Taiwan; Multidrug-resistant tuberculosis; Short-course Plus program; Treatment outcomes

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