Drug Resistant Tuberculosis among Tuberculosis Patients and Their Referral Rates

DOI: 10.6525/TEB.20160621.32(12).001

Ching-Han Liu, Yi-wen Cheng, Po-Wei Chu, Kwei-Feng Wang, Ru-Wen Jou, Yen-Fang Huang, Chang-Hsun Chen, Pei-Chun Chan^＊

2016 Vol.32 NO.12

Correspondence Author： Pei-Chun Chan^＊

Abstract：

The World Health Organization (WHO) proposed a DOTS-plus (Directly Observed Therapy Strategies-plus) policy in 1999, in the hopes of treating multi-drug resistant TB (MDR-TB) properly and reducing the transmission of MDR-TB within communities. In 2006, the WHO stated that extensive drug-resistant tuberculosis (XDR-TB) is a serious threat to public health globally.

The Taiwan Multidrug-resistant TB Consortium (TMTC) was established in May 2007. TMTC is composed of five professional medical care teams responsible for treating MDR-TB patients; it trains designated DOTS workers to provide comprehensive and professional DOTS-plus service in communities. Earlier detection of MDR-TB patients makes the referring process to TMTC more efficient. The purpose of this study is to calculate case finding and referral rates for MDR-TB patients enrolled with the TMTC.

For pulmonary TB patients who (1) registered as new or relapsed in the National TB Registry between February 2015–April 2015; and (2) had a culture-proven diagnosis, 98.5% had drug susceptibility test (DST) results. Of the 2122 patients with DST results, 37 patients (1.7%) were with rifampicin resistance, and 3 patients (0.1%) were with three or more anti-TB drugs resistance. Among 31 MDR-TB patients who met TMTC enrollment criteria, 23 (74.2 %) were referred. Patients not being referred to TMTC included 2 with MDR-TB (25%, 2/8), 5 with RR-TB (62.5%, 5/8), and 1 with three or more drug-resistant TB (12.5%, 1/8).