Treatment outcome of multi-drug resistance tuberculosis (MDR-TB) during 2003-2007 at Prapokklao Hospital.

Abstract

Background : Multi-drug resistance tuberculosis (MDR-TB) has been a widespread disease with critically high level in some parts of Thailand. Its treatment outcome and incidence in Chantaburi Province have never been evaluated.

Method : Data of MDR-TB cases, treated at Prapokklao Hospital from the year 2003 to 2007, were retrospectively reviewed and analyzed for its treatment outcome and incidence.

Result : There were a total of 103 MDR-TB patients, with 77 males and 26 females. Most were in the working age, ranging between 20-59 years, and lived in the urban area. The first three occupation frequently found to have MDR-TB are hired worker, prisoner and agriculturist. Among various body specimens, sputum had the highest rate of positive result (77.67 percent) leading to diagnosis of MDRTB.AIDS is the most frequent associated disease (31.07 percent) among several others. MDR-TB could occur in any body organ. The treatment outcome of MDRTB patients differed obviously from those without drug resistance. MDR-TB cases had a lower likelyhood of accomplishing a completed course of treatment, leading to higher treatment failure and death rate. Although the incidence of MDR-TB was low at 2 percent, the primary drug resistance tends to rise continually.Besides, we found new 7 cases of XDR-TB, the first report.

Conclusion : This is the first report of treatment outcome and incidence of MDR-TB and XDR-TB in Chantaburi Province. Although its incidence was still not high, it should be watched closely, since the chance of accomplishing a full, completed course of treatment was low for these patients, leading to higher treatment failure and death rate.