Free Content Drug resistance among smear-positive tuberculosis patients in Ho Chi Minh City, Vietnam

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OBJECTIVES: To assess the pattern of drug resistance among smear-positive tuberculosis (TB) patients in an inner city area in Vietnam.

METHODS: A random sample of patients diagnosed by the national TB programme (NTP) were offered HIV testing and submitted sputum for Mycobacterium tuberculosis drug sensitivity testing.

RESULTS: Of 1433 isolates from new patients, 360 (25%) were resistant to isoniazid (INH), 57 (4.0%) to rifampicin (RMP), 421 (29%) to streptomycin (SM) and 28 (2.0%) to ethambutol. Among 401 previously treated patients, this was 218 (54%), 109 (27%), 217 (54%) and 26 (7%), respectively. Multidrug resistance (MDR) was observed in 55 (3.8%) new and 102 (25%) previously treated patients. RMP resistance was strongly associated with resistance to INH (OR 46) and INH plus SM (OR 91, P = 0.004). Prevalence of drug resistance tended to decrease with age. Neither any resistance nor MDR was significantly associated with HIV infection.

CONCLUSIONS: In this inner city area, levels of drug resistance, in particular of MDR among previously treated patients, are high. This may be related to the use of NTP regimens in the context of highly prevalent combined SM and INH resistance which may favour acquisition of RMP resistance.

Keywords: HIV; Vietnam; drug resistance; risk factors; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Pham Ngoc Thach TB and Lung Disease Hospital, Ho Chi Minh City, Vietnam 2: KNCV Tuberculosis Foundation, The Hague, The Netherlands; and Academic Medical Center, Amsterdam, The Netherlands 3: KNCV Tuberculosis Foundation, The Hague, The Netherlands; and Stop TB, World Health Organization, Geneva, Switzerland

Publication date: February 1, 2006

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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.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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