Chih‑Bin Lina, Hung‑Chieh Sunb, Chen‑Yuan Chiangc,d, Che‑Wei Wue, Hsu‑Wen Chouf, Tao‑Qian Tangg, Jen‑Jyh Leea*
aDepartment of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan, bDepartment of Internal Medicine, Mennonite Christian Hospital, Hualien, Taiwan, cInternational Union Against Tuberculosis and Lung Disease, Paris, France, dDepartment of Internal Medicine, Wan Fang Hospital and School of Medicine, Taipei Medical University, Taipei, Taiwan, eDepartment of Internal Medicine, Mackay Memorial Hospital Taitung Branch, Taitung, Taiwan, fGraduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, gDivision of General Internal Medicine, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation
Abstract
Objectives: The objective of this study is to evaluate the treatment outcomes of patients with multidrug‑resistant tuberculosis (MDR‑TB) under special programmatic management in Eastern Taiwan over the past 10 years. Materials and Methods: All newly diagnosed MDR‑TB patients and MDR‑TB patients enrolled previously with persistent positive cultures were included in this study, from May 2007 to April 2017, in Eastern Taiwan. A panel of pulmonologists designed the initial MDR‑TB regimens. Subsequently, regimens
were adjusted according to drug susceptibility test results for second‑line drugs. Mobile teams were organized for treatment support, and several measures were adapted to safeguard effective treatment support. Results: A total of 178 patients with bacteriological confirmed pulmonary MDR‑TB were identified, of whom 167 had treatment outcomes when the study was conducted. Of these 167 patients, 120 (71.9%) were cured, 11 (6.5%) completed therapy (78.4% had successful treatment), 25 (15.0%) died, 9 (5.4%) had treatment failure, none were transferred out, and 2 (1.2%) were lost to follow‑up. Surgery was performed on 8 (4.8%). Conclusions: This is an analysis of the treatment outcomes after adopting the Directly Observed Treatment, Short‑course Plus program to treat MDR‑TB patients in Eastern Taiwan. We had a low proportion of loss‑to‑follow‑up, resulting in a high treatment success rate. This program serves as an effective model in providing quality care to patients with MDR‑TB.
Keywords: Directly observed treatment, Short‑course Plus program, Eastern Taiwan, Multidrug‑resistant tuberculosis, Treatment outcomes
