TY - JOUR T1 - High initial multidrug-resistant tuberculosis rate in Buenaventura, Colombia: a public–private initiative JF - European Respiratory Journal JO - Eur Respir J SP - 1569 LP - 1572 DO - 10.1183/09031936.00018212 VL - 40 IS - 6 AU - Sonia L. Villegas AU - Beatriz E. Ferro AU - Carlos M. Perez-Velez AU - Cesar A. Moreira AU - Liliana Forero AU - Ernesto Martínez AU - Nalin Rastogi AU - Jose Antonio Caminero Y1 - 2012/12/01 UR - http://erj.ersjournals.com/content/40/6/1569.abstract N2 - To the Editors:Multidrug-resistant tuberculosis (MDR-TB) is defined as TB resistant to at least isoniazid and rifampicin and globally accounts for approximately 500,000 new cases and 150,000 deaths each year [1]. In the latest nationwide anti-TB drug resistance survey carried out in Colombia (2005), MDR-TB accounted for 2.4% of new cases (initial MDR-TB) and 31.4% of previously treated cases [2]. Colombia has 32 departments, 11,000 TB cases per year and three laboratories to perform drug susceptibility testing (DST). Valle del Cauca is the third most populated department and the one with the highest TB caseloads in Colombia, where previous studies had reported 6% of initial MDR-TB [3], suggesting that the problem may be greater than in the rest of the country.A public–private initiative (PPI) led by the Secretariat of Public Health (SPH) of Valle del Cauca and the Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM) was established to assess the anti-TB drug-resistance situation in this department between January 2007 and December 2008, through operational research. The cities were weighted based on elevated rates of TB: Cali and Buenaventura, which represent 70% of the total caseload in the department (1,700 cases per year). This study was approved by the Ethics Committee of CIDEIM.Included cases were the following: smear-positive pulmonary TB, previously-untreated and/or previously-treated (including relapse, reinfection and treatment failures or defaulters), residing in the city during the last 12 months, regardless of age. Both public and private health facilities in Cali and Buenaventura were invited to submit fresh sputum samples or isolates of acid-fast bacilli of these cases. In Cali, the local TB … ER -