Abstract
Introduction: As countries in Africa scale up their treatment of multidrug-resistant tuberculosis (MDR-TB) patients, it is important to monitor the results of treatment efforts.
Methods: In 2010, as part of its global TB surveillance activities, the World Health Organization gathered information on treatment outcome cohorts of MDR-TB patients starting treatment in 2007. The delay allowed programmes time to recover data for patients whose treatment commonly lasts two years or more.
Results: Seventeen of the 46 countries in the African region reported treatment outcomes for an aggregate of 4523 MDR-TB cases, mostly from South Africa (3815). Thirteen of these countries had notified a total of 8234 MDR cases in 2007 (4 countries had no data), and outcome cohorts varied in size between 20% and >100% of cases originally notified. Outcome reports were incomplete with five national cohorts having no information on >20% of the patients treated. Treatment success ranged between countries from 14% to 100% of patients (median: 60%) and deaths from 0% to 57% (median: 14%). Defaults were more frequently reported (12 countries; median 9%) than failures (5 countries; median 0%).
Conclusions: Coverage and success in the African cohorts are comparable with other regions in the world. Reports on enrolment of MDR-TB patients on treatment and their outcomes are incomplete in many countries even when compared to original MDR notifications by the countries. This is a result of low capacity for scaling up care and ineffective reporting. Treatment success for MDR-TB patients remains low as a result of a high risk of dying, of failed treatment or of interruption of prescribed treatment.
- © 2011 ERS
