Faculty Collaboration Database

Impact of universal drug susceptibility testing and effective management of multidrug-resistant tuberculosis in Taiwan. PLoS One 2019;14(4):e0214792

Date

04/03/2019

Pubmed ID

30939150

Pubmed Central ID

PMC6445419

DOI

10.1371/journal.pone.0214792

Scopus ID

2-s2.0-85063689178 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

BACKGROUND: The treatment outcomes of multidrug-resistant tuberculosis (MDR-TB) patients in the 1990s in Taiwan was not satisfactory. To strengthen programmatic management of drug-resistant tuberculosis (PMDT), Taiwan MDR-TB Consortium (TMTC) was established in 2007. We assess the performance and epidemiologic impact of TMTC.

METHODOLOGY/PRINCIPLE FINDINGS: We analyzed the trends of proportion of TB cases with drug susceptibility testing, enrollment of MDR-TB patients into TMTC and outcomes of treatment of all MDR-TB patients in Taiwan from 2007-2016. We computed the trends of both incidence and prevalence of MDR-TB from 2007-2016. We assessed the trends of MDR-TB among both new and recurrent TB cases. The proportion of TB cases with drug susceptibility testing results increased from 24.2% in 2007 to 97.9% in 2016. Of the 1,452 MDR-TB patients who were eligible for TMTC care, 1,197 (82.4%) were enrolled in TMTC, in whom 82.9% had treatment success. MDR-TB incidence was 9.0 cases per million in 2007, which declined to 4.6 cases per million in 2016 (p<0.0001). MDR-TB prevalence decreased from 19.4 cases per million in 2007 to 8.4 cases per million in 2016 (p<0.0001). The proportion of MDR-TB among new TB cases decreased from 1.4% in 2010 to 1.0% in 2016 (p = 0.039); and that among recurrent TB cases from 9.0% in 2010 to 1.8% in 2016 (p<0.0001).

CONCLUSIONS: We concluded that effective PMDT have had a significant impact on the epidemic of drug-resistant TB in Taiwan.

Author List

Lee PH, Chan PC, Peng YT, Chu PW, Wu MH, Jou R, Yu MC, Lin CJ, Huang YW, Chien ST, Lee JJ, Chiang CY

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antitubercular Agents
Directly Observed Therapy
Female
Humans
Incidence
Male
Microbial Sensitivity Tests
Middle Aged
Mycobacterium tuberculosis
Taiwan
Treatment Outcome
Tuberculosis, Multidrug-Resistant
Young Adult