Volume 12, Number 9—September 2006
Research
Multidrug-resistant Tuberculosis Management in Resource-limited Settings
Eva Nathanson*
, 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*
, 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*
Table 4
Multidrug-resistant tuberculosis control program cohort characteristics*
| Characteristic | Estonia, n (%) | Latvia, n (%) | Lima, n (%) | Manila, n (%) | Tomsk, n (%) | Total, n (%) |
|---|---|---|---|---|---|---|
| Total no. cases | 46 (100.0) | 245 (100.0) | 508 (100.0) | 105 (100.0) | 143 (100.0) | 1,047 (100.0) |
| New cases | 22 (47.8) | 91 (37.1) | 1 (0.2) | 5 (4.8) | 0 | 119 (11.4) |
| Previously treated cases | 24 (52.2) | 154 (62.9) | 507 (99.8) | 100 (95.2) | 143 (100.0) | 928 (88.6) |
| Cases previously treated with first-line drugs | 19 (79.2) | 132 (85.7) | 125 (25.0)† | 53 (54.6)† | 109 (76.2) | 438 (47.7) |
| Cases previously treated with first- and second-line drugs | 5 (20.8) | 22 (14.3) | 376 (75.0)† | 44 (45.4)† | 34 (23.8) | 481 (52.3) |
| Resistance to only H and R | 0 | 7 (2.9) | 11 (2.2) | 9 (8.6) | 0 | 27 (2.6) |
| Resistance to only H, R, and other first-line drugs | 0 | 78 (31.8) | 182 (35.8) | 26 (24.8) | 55 (38.5) | 341 (32.6) |
| Resistance to first- and second-line drugs | 46 (100.0) | 160 (65.3) | 315 (62.0) | 70 (66.7) | 88 (61.5) | 679 (64.9) |
| Treatment cessation because of adverse events | 3 (6.5) | 5 (2.0) | NA | 9 (8.6) | 0 | 17 (3.2) |
| HIV coinfection | 0 | 11 (4.5) | 5 (1.0) | NA | 0 | 16 (1.7) |
| Surgery performed | 1 (2.2) | 18 (7.3) | 78 (15.4) | 0 | 17 (11.9) | 114 (10.9) |
| No. patients hospitalized | 41 (89.1) | 245 (100.0) | NA | 5 (5.0) | 71 (49.7) | 362 (67.2) |
| Average no. drugs in treatment regimen | 5.4 | 5.5 | NA | 6.28 | 5.3 |
*H, isoniazid; R, rifampin; NA, not applicable.
†Information is lacking from 6 patients (Lima) and 3 patients (Manila) on previous treatment with first-line drugs only or with first- and second-line drugs.
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