Abstract
In the present study, we characterised drug-resistance patterns, compared treatment outcome between extensively and nonextensively drug-resistant tuberculosis (non-XDR-TB) cases, and assessed risk factors for poor outcome in a high-prevalence country that screens all TB patients for first-line anti-TB drug resistance.
We reviewed drug susceptibility test results among all pulmonary TB cases in Latvia diagnosed from 2000–2004, as well as demographic and clinical characteristics, drug-resistance patterns, and treatment outcomes.
During the 5-yr period, 1,027 multidrug-resistant tuberculosis (MDR-TB) cases initiated treatment. Among all cases, the proportion that experienced an outcome of cure or completion increased from 66.2 to 70.2% (p = 0.06 for linear trend). Among the 48 (4.7%) XDR-TB cases, 18 (38%) were cured, four (8%) died, three (6%) defaulted, and treatment failed in 23 (48%). In proportional-hazards analysis, characteristics significantly associated with poor outcome included XDR-TB, being retired, presence of bilateral cavitation, and previous MDR-TB treatment history for those aged ≥55 yrs.
Overall, treatment success among all MDR-TB cases increased over time. Strategies to prevent transmission of XDR-TB and to further improve treatment outcome are crucial for the future of TB control in Latvia.
Footnotes
For editorial comments see page 475.
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Support Statement
Funding for this study was provided by the Latvian Ministry of Health. A small amount was contributed by the US Agency for International Development to support technical assistance to the project, but they had no role in the conduct of the study.
Statement of Interest
None declared.
- Received January 7, 2010.
- Accepted January 15, 2010.
- ©2010 ERS
