An integrated MDR-TB management programme results in favourable outcomes in northern Taiwan

Multidrug-resistant tuberculosis (MDR-TB) is caused by Mycobacterium tuberculosis that is resistant to at least isoniazid (INH) and rifampicin (RIF). MDR-TB is difficult to treat and has become an obstacle to tuberculosis control programmes worldwide [1]. The global burden of MDR-TB has been increasing and the World Health Organization (WHO) estimated there were 450 000 incident MDR-TB cases in 2012 [2]. Based on drug-resistance surveys, 3.6% of patients newly diagnosed and 20.2% of patients previously treated for tuberculosis had MDR-TB [2]. MDR-TB demands treatment with second-line drugs that have a limited sterilising capacity, and are less effective and more toxic than first-line drugs. Among the estimated 20% of the worldwide MDR-TB cases that were enrolled in treatment in 2010, only 48% were successfully treated [2]. High mortality rates and loss to follow-up are threatening to destabilise global tuberculosis control. Despite numerous risk factors, a patient-centred management programme resulted in favourable outcomes for MDR-TB The authors would like to thank Mei-Hua Wu, Wei-Lun Huang, Pei-Chun Chuang and Ting-Fang Wang (Center for Research, Diagnostic and Vaccine Development, Centers for Disease Control, Taipei, Taiwan) for their excellent technical support.