Introduction of Medical Care System for Multi-drug Resistant Tuberculosis in Taiwan

Shu-Hua Huang

2009 Vol.25 NO.2

Correspondence Author： Shu-Hua Huang

Abstract：

Tuberculosis is the most severe infectious disease in the world as well as in Taiwan. Nearly 15,000 new cases are recorded every year in Taiwan. Factors such as the long period required for treatment and medical side effects make some patients take medicine irregularly, which is the main reason for the development of multiple-drug resistant tuberculosis (MDR TB).
The World Health Organization (WHO) warned in 2007 that the spread of MDR TB has become a major public health problem which is threatening the whole world. It thus recommended nations around the world to implement the “Directly Observed Treatment, Short-course, plus” (DOTS-plus) for preventing and controlling this disease.
The “Medical Care System for Multiple-drug Resistant Tuberculosis” was launched in May, 2007, in Taiwan. It consists of 5 medical care teams to receive MDR TB patients. Medical resources are provided by Taiwan CDC, and each medical care team is requested to conform to the WHO treatment guidelines for this disease. Each case is placed under rigorous treatment for 2 years. Besides the clinical treatment, social workers have been recruited for carrying out DOTS-plus in the community to provide patients with complete and continuous attention. A total of 171 MDR TB cases had been received and put under treatment as of November 2007.
This medical care system cooperates with the Bureau of National Health Insurance in managing the use of fluoroquinolone medications and in conducting spot-checks of the prescription of anti-tuberculosis medicine. This system also focuses on the management and improvement of quality control in the laboratories and has introduced more second-line anti-tuberculosis medicine into Taiwan. Through this system, we can improve the cure rate for MDR TB patients.
Keywords: multiple-drug resistant tuberculosis, DOTS-plus, medical care system