Nationwide drug resistance survey of tuberculosis in the Philippines

Int J Tuberc Lung Dis. 2009 Apr;13(4):500-7.

Abstract

Setting: The Philippines, one of the high tuberculosis (TB) burden countries.

Objective: To determine the prevalence of anti-tuberculosis drug resistance in the first nationwide systematic survey.

Design: A population-proportionate cluster sampling method was employed. Smear-positive pulmonary TB patients aged > or = 15 years were eligible. Drug susceptibility testing was performed against four first-line drugs, i.e., isoniazid, rifampicin, ethambutol and streptomycin.

Results: A total of 1091 patients were enrolled during a 17-month period starting in June 2003, of whom 935 (85.7%) were new cases and 121 (11.1%) previously treated cases. Resistance to any of the four drugs was seen in 20.4% (95%CI 18.1-22.9) of new cases, in 38.8% (95%CI 27.8-51.1) of previously treated cases and in 22.1% (19.7-24.9) of both new and previously treated cases combined. The prevalence of multidrug resistance was respectively 3.8% (95%CI 2.6-5.5), 20.9% (95%CI 13.0-32.0) and 5.7% (95%CI 4.3-7.5). The prevalence of drug resistance among new cases was higher than the global average and it was widespread throughout the country.

Conclusion: Confronted with the high prevalence of drug resistance, current efforts by the government to ensure better quality treatment programme should be strengthened.

MeSH terms

  • Adult
  • Antitubercular Agents / pharmacology
  • Data Collection
  • Female
  • Humans
  • Male
  • Middle Aged
  • Philippines / epidemiology
  • Prevalence
  • Tuberculosis, Multidrug-Resistant / epidemiology*

Substances

  • Antitubercular Agents