Nathanson Eva, Lambregts-van Weezenbeek Catharina, Rich Michael L, Gupta Rajesh, Bayona Jaime, Blöndal Kai, Caminero José A, Cegielski J Peter, Danilovits Manfred, Espinal Marcos A, Hollo Vahur, Jaramillo Ernesto, Leimane Vaira, Mitnick Carole D, Mukherjee Joia S, Nunn Paul, Pasechnikov Alexander, Tupasi Thelma, Wells Charles, Raviglione Mario C
Stop TB Department, World Health Organization, Geneva, Switzerland.
Emerg Infect Dis. 2006 Sep;12(9):1389-97. doi: 10.3201/eid1209.051618.
Evidence of successful management of multidrug-resistant tuberculosis (MDRTB) is mainly generated from referral hospitals in high-income countries. We evaluate the management of MDRTB in 5 resource-limited countries: Estonia, Latvia, Peru, the Philippines, and the Russian Federation. All projects were approved by the Green Light Committee for access to quality-assured second-line drugs provided at reduced price for MDRTB management. Of 1047 MDRTB patients evaluated, 119 (11%) were new, and 928 (89%) had received treatment previously. More than 50% of previously treated patients had received both first- and second-line drugs, and 65% of all patients had infections that were resistant to both first- and second-line drugs. Treatment was successful in 70% of all patients, but success rate was higher among new (77%) than among previously treated patients (69%). In resource-limited settings, treatment of MDRTB provided through, or in collaboration with, national TB programs can yield results similar to those from wealthier settings.
耐多药结核病（MDRTB）成功管理的证据主要来自高收入国家的转诊医院。我们评估了爱沙尼亚、拉脱维亚、秘鲁、菲律宾和俄罗斯联邦这5个资源有限国家的耐多药结核病管理情况。所有项目均获得绿灯委员会批准，可获取以降价提供的、用于耐多药结核病管理的质量有保证的二线药物。在评估的1047例耐多药结核病患者中，119例（11%）为新发病例，928例（89%）曾接受过治疗。超过50%的既往治疗患者同时接受过一线和二线药物治疗，所有患者中有65%的感染对一线和二线药物均耐药。所有患者中有70%治疗成功，但新发病例的成功率（77%）高于既往治疗患者（69%）。在资源有限的环境中，通过国家结核病规划或与国家结核病规划合作开展的耐多药结核病治疗可取得与较富裕环境相似的结果。
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