Authors: Ollé-Goig, J.E.¹; Sandy, R.²

Source: The International Journal of Tuberculosis and Lung Disease, Volume 9, Number 7, July 2005 , pp. 765-770(6)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: A tuberculosis (TB) out-patient service in the city of Santa Cruz, Bolivia.

OBJECTIVE: To evaluate the outcomes of patients with TB resistant to isoniazid and rifampicin (multidrug resistance [MDR]) treated in a resource-poor area before the introduction of the DOTS-Plus initiative.

DESIGN: Retrospective cohort study of MDR-TB patients treated with individualised regimens between January 1983 and December 1993.

RESULTS: Among 143 patients studied, 73 (51%) were males; the mean age was 33.9 years. Forty (28%) were new patients and 103 (72%) were previously treated patients. The treatment regimen had to be modified in 122 (85%) patients. A successful outcome was achieved in 41 (28%) patients; 68 (48%) defaulted, 18 (13%) died, and 14 (10%) were still under treatment in 1996.

CONCLUSIONS: The treatment approach described had dismal results. The capacity for performing drug susceptibility testing and the availability of several second-line anti-tuberculosis drugs were not sufficient to achieve cure in more than one third of the patients treated. Other factors, such as a set of standard procedures, clear guidelines for the treatment and follow-up of patients and the administration of directly observed treatment, must be included in a programme for treating MDR-TB, to obtain better treatment results.

Keywords: tuberculosis; multidrug resistance; Bolivia; DOTS Plus

Document Type: Regular paper

Affiliations: 1: St Francis Hospital, Buluba, Uganda; Catalan Association for the Control of Tuberculosis in the Third World (ACTMON), Barcelona, Spain; and German Leprosy Relief Association, (DAHW), Santa Cruz, Bolivia 2: Mycobacterial Laboratory, Red Cross Bronchopulmonary Centres/Kuratorium Tuberkulose in der Welt, Santa Cruz, Bolivia

Publication date: 2005-07-01

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• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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