Impact of Drug-reistance on TB
On individual TB patient: Difficulty in treating D-R TB in particular Multi-drug-resistant TB (MDRTB)
Often lower cure rate and higher incidence of side-effects of drugs.
On national TB control programme (NTP): More burden for NTP with less yields.
Source of infection of primary D-R TB.
Lower cure rate, higher fatality and treatment failure.
Higher cost for NTP.
Necessity for sophisticated treatment center particularly for MDRTB cases.
DOTS (Directly Observed Treatment, Short-course) is the best solution to achieve high cure rate and to prevent the emergence of D-R TB.
Perspective of MDRTB in Asia
Increase of MDRTB is anticipated in Asia due to the following:
(1) Short-course chemotherapy (SCC) has been introduced to most Asian countries, but the used regimen of chemotherapy is often not the one recommended by WHO.
(2) TB Case management is often inadequate in many countries. DOTS is not yet adopted in some countries.
(3) HIV epidemic has been invading into Asian and gives heavier burden to NTP.
Adoption of DOTS will determine the trend of D-R in Asia.
Surveillance system to monitor the prevalence of D-R should be organized including the establishment of reference laboratories both on national and regional levels, as the magnitude of D-R is one of key informations to evaluate the success of NTP.
