Extract
To the Editor:
Multidrug-resistant tuberculosis (MDR-TB) is caused by Mycobacterium tuberculosis that is resistant to at least isoniazid (INH) and rifampicin (RIF). MDR-TB is difficult to treat and has become an obstacle to tuberculosis control programmes worldwide. The global burden of MDR-TB has been increasing and the World Health Organization (WHO) estimated there were 450 000 incident MDR-TB cases in 2012. Based on drug-resistance surveys, 3.6% of patients newly diagnosed and 20.2% of patients previously treated for tuberculosis had MDR-TB. MDR-TB demands treatment with second-line drugs that have a limited sterilising capacity, and are less effective and more toxic than first-line drugs. Among the estimated 20% of the worldwide MDR-TB cases that were enrolled in treatment in 2010, only 48% were successfully treated. High mortality rates and loss to follow-up are threatening to destabilise global tuberculosis control.
In Taiwan, MDR-TB occurred in 1% of new tuberculosis cases and in 6% of re-treated tuberculosis cases. In addition, laboratory-based analyses revealed that 10% of MDR-TB cases in Taiwan were extensively drug-resistant (XDR-TB). Faced with the challenge of the low treatment success rate of MDR-TB, a designated, government-organised and hospital-initiated programme led by experienced pulmonary specialists with diligent case managers, and
- Received April 25, 2014.
- Accepted June 30, 2014.
- ©ERS