Impact of universal drug susceptibility testing and effective management of multidrug-resistant tuberculosis in Taiwan

Pin Hui Lee, Pei Chun Chan, Yen Ting Peng, Po Wei Chu, Mei Hua Wu, Ruwen Jou, Ming Chih Yu, Chou Jui Lin, Yi Wen Huang, Shun Tien Chien, Jen Jyh Lee, Chen Yuan Chiang

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Abstract

Background The treatment outcomes of multidrug-resistant tuberculosis (MDR-TB) patients in the 1990s in Taiwan was not satisfactory. To strengthen programmatic management of drug-resistant tuberculosis (PMDT), Taiwan MDR-TB Consortium (TMTC) was established in 2007. We assess the performance and epidemiologic impact of TMTC. Methodology/Principle findings We analyzed the trends of proportion of TB cases with drug susceptibility testing, enrollment of MDR-TB patients into TMTC and outcomes of treatment of all MDR-TB patients in Taiwan from 2007–2016. We computed the trends of both incidence and prevalence of MDR-TB from 2007–2016. We assessed the trends of MDR-TB among both new and recurrent TB cases. The proportion of TB cases with drug susceptibility testing results increased from 24.2% in 2007 to 97.9% in 2016. Of the 1,452 MDR-TB patients who were eligible for TMTC care, 1,197 (82.4%) were enrolled in TMTC, in whom 82.9% had treatment success. MDRTB incidence was 9.0 cases per million in 2007, which declined to 4.6 cases per million in 2016 (p<0.0001). MDR-TB prevalence decreased from 19.4 cases per million in 2007 to 8.4 cases per million in 2016 (p<0.0001). The proportion of MDR-TB among new TB cases decreased from 1.4% in 2010 to 1.0% in 2016 (p = 0.039); and that among recurrent TB cases from 9.0% in 2010 to 1.8% in 2016 (p<0.0001). Conclusions We concluded that effective PMDT have had a significant impact on the epidemic of drug-resistant TB in Taiwan.

Original languageEnglish
Article numbere0214792
JournalPLoS One
Volume14
Issue number4
DOIs
Publication statusPublished - Apr 1 2019

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ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Lee, P. H., Chan, P. C., Peng, Y. T., Chu, P. W., Wu, M. H., Jou, R., Yu, M. C., Lin, C. J., Huang, Y. W., Chien, S. T., Lee, J. J., & Chiang, C. Y. (2019). Impact of universal drug susceptibility testing and effective management of multidrug-resistant tuberculosis in Taiwan. PLoS One, 14(4), [e0214792]. https://doi.org/10.1371/journal.pone.0214792