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Free Content Screening outcomes from patients with suspected multidrug-resistant tuberculosis: lessons learned in the Philippines

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Abstract:

SETTING: The high prevalence of multidrug-resistant tuberculosis (MDR-TB) in the Philippines is a challenge for the National TB Programme.

OBJECTIVE: To assess patterns of drug resistance and screening outcomes among MDR-TB suspects evaluated from 2003 to 2008 at DOTS-Plus clinics in the Philippines.

METHODS: Descriptive study of 4897 consecutive patients with suspected MDR-TB.

RESULTS: The median time from the first visit until a diagnosis of drug-resistant TB was 132 days (IQR 110–166 days). Among patients screened for MDR-TB, the most frequent resistance pattern among those previously treated in DOTS facilities was resistance to isoniazid (INH) and rifampicin (RMP). Resistance to INH+RMP plus fluoroquinolones was the most common pattern among those who had failed Category II treatment and patients treated by non-DOTS facilities. Among patients with MDR-TB, 57% ultimately received appropriate treatment with second-line drugs. The remaining 43% were lost to follow-up (25%), died (14%) or refused treatment (4%).

CONCLUSION: Resistance to INH+RMP is the most frequent resistance pattern among patients referred from DOTS clinics in the Philippines for suspected MDR-TB. Initial use of standard regimens based on national survey data and quick uptake of new rapid molecular resistance tests may be useful to reduce diagnostic delays and expedite treatment for drug-resistant TB.

Keywords: MDR-TB; high-burden countries; treatment

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.12.0038

Affiliations: Tropical Disease Foundation, Makati City, Philippines

Publication date: October 1, 2012

More about this publication?
  • 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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