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