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Volume 12, Number 9—September 2006

Multidrug-resistant Tuberculosis Management in Resource-limited Settings

Eva Nathanson*Comments to Author , Catharina Lambregts-van Weezenbeek†, Michael Rich‡, Rajesh Gupta*, Jaime Bayona‡§, Kai Blöndal†, José A. Caminero¶, J. Peter Cegielski#, Manfred Danilovits**, Marcos A. Espinal*, Vahur Hollo††, Ernesto Jaramillo*, Vaira Leimane‡‡, Carole D. Mitnick§§, Joia S. Mukherjee§§, Paul Nunn*, Alexander Pasechnikov‡¶¶, Thelma E. Tupasi##, Charles Wells#, and Mario C. Raviglione*
Author affiliations: *World Health Organization, Geneva, Switzerland; †KNCV Tuberculosis Foundation, The Hague, the Netherlands; ‡Partners In Health, Boston, Massachusetts, USA; §Socios En Salud, Lima, Peru; ¶International Union Against Tuberculosis and Lung Disease, Paris, France; #Centers for Disease Control and Prevention, Atlanta, Georgia, USA; **Tartu University Clinics, Tartu, Estonia; ††National TB Programme, Tallinn, Estonia; ‡‡State Centre of Tuberculosis and Lung Diseases of Latvia, Riga, Latvia; §§Harvard Medical School, Boston, Massachusetts, USA; ¶¶MDR-TB Project in Tomsk Oblast, Tomsk, Russian Federation; ##Makati Medical Center, Makati, the Philippines

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Table 1

Treatment outcome definitions for multidrug-resistant tuberculosis (MDRTB) patients (14)

Category Definition
Cure Completed treatment according to country protocol and been consistently culture-negative (>5 results) for final 12 mo of treatment. If only 1 positive culture is reported during that time with no concomitant clinical evidence of deterioration, patient may still be considered cured, provided that positive culture is followed by >3 consecutive negative cultures taken >30 d apart.
Treatment completed Completed treatment according to country protocol but does not meet definition for cure or treatment failure because of lack of bacteriologic results (i.e., <5 cultures were performed in the final 12 mo of therapy).
Death Died for any reason during the course of MDRTB treatment.
Treatment default Treatment was interrupted for >2 consecutive months for any reason.
Treatment failure >2 of 5 cultures recorded in the final 12 mo are positive or if any of the final 3 cultures is positive. Treatment will also be considered to have failed if a clinical decision has been made to terminate treatment early due to poor response or adverse events.
Transfer out Transferred to another reporting and recording unit and the treatment outcome is unknown.

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Page created: November 17, 2011
Page updated: November 17, 2011
Page reviewed: November 17, 2011
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