Abstract
Despite the steady decline of TB incidence, the occurrence of multidrug-resistant and extensively drug-resistant tuberculosis (M/XDR-TB) is a threat to all effort to control TB in Europe.
In 2013, in Europe 14% of new TB cases and 44% of previously treated cases are estimated to be MDR-TB and 29.8% XDR-TB [1]. In Portugal, MDR-TB was reported for 1, 6 % of cases with drug-susceptibility testing (DST) results, and 29% of which had criteria for XDR [2].
In Portugal, in 2007 the National Reference Centre for M/XDR-TB was created within the specific strategies to control MDR-TB. The Regional Reference Centres were created later. The Northern Regional Reference Centre (NRRC) started its activity in July 2009, one of the first in the country.
This NRRC is responsible for the clinical management of MDR-TB patients, including the choice and adjustment according to the adverse effects of treatment regimen, and the determination of need for hospitalization.
We evaluated the trend of M/XDR-TB, the prevalence of HIV, duration of treatment, the occurrence of adverse events and treatment outcome in the periods 2004-2008 and 2009-2013, using data from the National Tuberculosis Vigilance System (SVIG-TB) and from clinical reports. In the periods studied the death rate was 24% and 18% respectively. The treatment success rate was 70% and 75%. The prevalence of HIV and the occurrence of the toxicity during treatment were lower during the period of the operation of the NRRC (2009-2013).
We conclude that the operation of the NRRC contributed to an improvement of the MDR-TB case management and treatment outcome in the region.
- Copyright ©ERS 2015