SETTING: The Philippines, a high burden country for tuberculosis (TB). STUDY DESIGN: Health Operational Study. OBJECTIVE: To describe preliminary data from the Makati Medical Center (MMC)-DOTS Plus pilot project. METHODS: Patients were consecutively enrolled after confirmation of MDR-TB status. Individualized treatment regimens were based on drug susceptibility testing and history of previous intake for the other drugs that were not tested. Treatment outcome in those who had completed at least 18 months of therapy and interim outcome for those who received more than 12 months but less than 18 months were analyzed. RESULTS: One hundred forty-nine patients with MDR-TB were enrolled from April 1999 to 30 May 2002 at the MMC DOTS Clinic. Referrals were from private institutions and practicing physicians in 73.2% of cases. Approximately 30% of isolates tested were resistant to all five first-line drugs, 39.4% to four, 16.8% to three, 12.1% to two. Fluoroquinolone resistance was noted in 40.9% of all the isolates, including 54.5% of those resistant to five drugs and 34.6% of those resistant to four drugs. The outcome of 23 patients who completed therapy and 62 who have received more than 12 months therapy showed cure and likely cure in 73.4% of cases and failure in 3.8% and likely failure in 6.3%. Death occurred in 3.8% and default was observed in 11.4%. CONCLUSION: The MMC DOTS-Plus pilot project is a public-private collaboration in TB Control. Response to therapy was encouraging. Complete subsidy of medicines and laboratory and clinic services and DOT were essential in the successful implementation of the program. DOTS-Plus and DOTS should go hand in hand in TB control if MDR-TB is highly prevalent.
SETTING: The Philippines, a high burden country for tuberculosis (TB). STUDY DESIGN: Health Operational Study. OBJECTIVE: To describe preliminary data from the Makati Medical Center (MMC)-DOTS Plus pilot project. METHODS:Patients were consecutively enrolled after confirmation of MDR-TB status. Individualized treatment regimens were based on drug susceptibility testing and history of previous intake for the other drugs that were not tested. Treatment outcome in those who had completed at least 18 months of therapy and interim outcome for those who received more than 12 months but less than 18 months were analyzed. RESULTS: One hundred forty-nine patients with MDR-TB were enrolled from April 1999 to 30 May 2002 at the MMC DOTS Clinic. Referrals were from private institutions and practicing physicians in 73.2% of cases. Approximately 30% of isolates tested were resistant to all five first-line drugs, 39.4% to four, 16.8% to three, 12.1% to two. Fluoroquinolone resistance was noted in 40.9% of all the isolates, including 54.5% of those resistant to five drugs and 34.6% of those resistant to four drugs. The outcome of 23 patients who completed therapy and 62 who have received more than 12 months therapy showed cure and likely cure in 73.4% of cases and failure in 3.8% and likely failure in 6.3%. Death occurred in 3.8% and default was observed in 11.4%. CONCLUSION: The MMC DOTS-Plus pilot project is a public-private collaboration in TB Control. Response to therapy was encouraging. Complete subsidy of medicines and laboratory and clinic services and DOT were essential in the successful implementation of the program. DOTS-Plus and DOTS should go hand in hand in TB control if MDR-TB is highly prevalent.
Authors: Shama D Ahuja; David Ashkin; Monika Avendano; Rita Banerjee; Melissa Bauer; Jamie N Bayona; Mercedes C Becerra; Andrea Benedetti; Marcos Burgos; Rosella Centis; Eward D Chan; Chen-Yuan Chiang; Helen Cox; Lia D'Ambrosio; Kathy DeRiemer; Nguyen Huy Dung; Donald Enarson; Dennis Falzon; Katherine Flanagan; Jennifer Flood; Maria L Garcia-Garcia; Neel Gandhi; Reuben M Granich; Maria G Hollm-Delgado; Timothy H Holtz; Michael D Iseman; Leah G Jarlsberg; Salmaan Keshavjee; Hye-Ryoun Kim; Won-Jung Koh; Joey Lancaster; Christophe Lange; Wiel C M de Lange; Vaira Leimane; Chi Chiu Leung; Jiehui Li; Dick Menzies; Giovanni B Migliori; Sergey P Mishustin; Carole D Mitnick; Masa Narita; Philly O'Riordan; Madhukar Pai; Domingo Palmero; Seung-kyu Park; Geoffrey Pasvol; Jose Peña; Carlos Pérez-Guzmán; Maria I D Quelapio; Alfredo Ponce-de-Leon; Vija Riekstina; Jerome Robert; Sarah Royce; H Simon Schaaf; Kwonjune J Seung; Lena Shah; Tae Sun Shim; Sonya S Shin; Yuji Shiraishi; José Sifuentes-Osornio; Giovanni Sotgiu; Matthew J Strand; Payam Tabarsi; Thelma E Tupasi; Robert van Altena; Martie Van der Walt; Tjip S Van der Werf; Mario H Vargas; Pirett Viiklepp; Janice Westenhouse; Wing Wai Yew; Jae-Joon Yim Journal: PLoS Med Date: 2012-08-28 Impact factor: 11.069
Authors: Irene G Sia; Seanne P Buckwalter; Kelly A Doerr; Sonia Lugos; Rebecca Kramer; Ruth Orillaza-Chi; Maria Imelda Quelapio; Thelma E Tupasi; Nancy L Wengenack Journal: BMC Infect Dis Date: 2013-12-05 Impact factor: 3.090
Authors: Thelma E Tupasi; Anna Marie Celina G Garfin; Ekaterina V Kurbatova; Joan M Mangan; Ruth Orillaza-Chi; Leilani C Naval; Glenn I Balane; Ramon Basilio; Alexander Golubkov; Evelyn S Joson; Woo-Jin Lew; Vivian Lofranco; Mariquita Mantala; Stuart Pancho; Jesus N Sarol Journal: Emerg Infect Dis Date: 2016-03 Impact factor: 6.883