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Free Content Highly successful treatment outcome of multidrug-resistant tuberculosis in the Netherlands, 2000–2009

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SETTING: Resistance to the two key anti-tuberculosis drugs isoniazid and rifampicin is a characteristic of multidrug-resistant tuberculosis (MDR-TB). MDR-TB is a scourge requiring toxic, prolonged treatment and is associated with poor outcomes. The Netherlands is a country with a long-standing, integrated, well-resourced TB service where all patients are offered culture-confirmed diagnosis by a central reference laboratory.

OBJECTIVE: To assess the treatment outcomes of MDR-TB patients over a period of 10 years in The Netherlands.

DESIGN: Demographic, clinical and microbiological features of all patients with MDR-TB who started treatment in 2000–2009 in the Netherlands were analysed from national registry and patient records.

RESULTS: Characteristics of the 113 MDR-TB patients were as follows: male/female ratio 1.57, 96% foreign born, median age 29 years, 96 (85%) pulmonary TB, 56 (50%) smear-positive, 14 (12%) human immunodeficiency virus (HIV) co-infected. Of the 104 (92%) patients who started MDR-TB treatment, 86% had a successful outcome using a median of six active drugs; eight underwent pulmonary surgery. HIV negativity was associated with successful outcome (adjusted OR 2.1, 95%CI 1.1–3.8).

CONCLUSION: High success rates for MDR-TB treatment were achieved with close collaboration of all stakeholders, reaching the targets set for drug-susceptible TB. HIV remained an independent risk factor for unsuccessful treatment outcome.
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Keywords: HIV; MDR-TB; drug susceptibility testing; outcome; public health; therapeutic drug monitoring

Document Type: Research Article

Affiliations: 1: Tuberculosis Center Beatrixoord, University Medical Center Groningen, Department of Pulmonary Medicine & Tuberculosis, University of Groningen, Haren, The Netherlands 2: KNCV Tuberculosis Foundation, The Hague, The Netherlands; Centre for Infectious Diseases, National Institute of Public Health and the Environment, Bilthoven, The Netherlands 3: Tuberculosis Center, University Center for Chronic Diseases Dekkerswald, Radboud Nijmegen University Medical Center, Nijmegen, The Netherlands 4: KNCV Tuberculosis Foundation, The Hague, The Netherlands; Academic Medical Center, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands 5: Tuberculosis Reference Laboratory, Centre for Infectious Diseases, National Institute for Health and the Environment (RIVM), Bilthoven, The Netherlands; Departments of Medical Microbiology and Lung Disease, Radboud Nijmegen University Medical Center, Nijmegen, The Netherlands 6: Tuberculosis Center Beatrixoord, University Medical Center Groningen, Department of Pulmonary Medicine & Tuberculosis, University of Groningen, Haren, The Netherlands; University Medical Center Groningen, Department of Internal Medicine, Infectious Diseases, University of Groningen, The Netherlands

Publication date: April 1, 2015

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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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