AB 99. Multi - drug resistance in tuberculosis

The latest WHO reports has confirmed general concern: antituberculosis drug resistance is widespread, and MDR-TB is extremely high in some parts of the world. The aim of this study was to determine the influence of drug-resistant TB, especially its MDR TB forms on the course and outcomes of these patients. The incidence of resistant tuberculosis in Vojvodina between 2000-2009 is also determined. It is proved that resistance in this region is mostly acquired, but high percentage of MDR TB among new cases emphasizes the importance of disease spread between contacts.The most important risk factors for the MDR TB are shown to be previous hospitalizations for tuberculosis, alcoholism, poor social status and poverty. The presence of drug resistance in MDR TB group has led to longer duration of treatment, slower sputum conversion and higher percentage of deaths and more patients with poor disease outcome. Implementation of the DOTS strategy has contributed to the reduction of mono and polyresistant tuberculosis, but not MDR TB cases. This strategy has also improved treatment outcome, reduced mortality and time of sputum conversion in all forms of drug-resistant tuberculosis. Survey results are speaking in favour of the DOTS strategy, but we expect a lot more from the DOTS Plus program,which is introduced in Serbia and Vojvodina in September 2009.