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ABSTRACT: Setting
Nationwide Canadian public health surveillance.Objective
Description of demographic features and disease characteristics of drug-resistant tuberculosis (TB) in Canada over a 12 year period.Design
Continuous surveillance of all cases of culture-confirmed TB in Canada. Demographic and microbiologic features were analyzed and comparisons between drug-susceptible, multidrug-resistant (MDR), and drug-resistant not-MDR were made. Cases of extensively drug resistant TB are described.Results
15,993 cases of culture-confirmed TB were reported during the study period. There were 5 cases of XDR-TB, 177 cases of MDR-TB, and 1,234 cases of first-line drug resistance not-MDR. The majority of drug-resistant cases were reported in foreign-born individuals, with drug-resistant cases diagnosed earlier post-arrival in Canada compared to drug-susceptible cases. In MDR-TB isolates, there was a high rate of drug-resistance to other first- and second-line drugs, making reliable empiric therapeutic recommendations for MDR-TB difficult. There was a statistically significant association between both MDR and drug-resistance not-MDR, and the risk of a negative treatment outcome (defined as treatment failure, absconded, or treatment ongoing >3 yrs).Conclusion
Drug-resistance complicates TB management even in developed nations with well-established TB control programs. The predominantly international origin of drug-resistant cases highlights the need for global strategies to combat TB.
SUBMITTER: Minion J
PROVIDER: S-EPMC3541271 | biostudies-literature | 2013
REPOSITORIES: biostudies-literature
Minion Jessica J Gallant Victor V Wolfe Joyce J Jamieson Frances F Long Richard R
PloS one 20130109 1
<h4>Setting</h4>Nationwide Canadian public health surveillance.<h4>Objective</h4>Description of demographic features and disease characteristics of drug-resistant tuberculosis (TB) in Canada over a 12 year period.<h4>Design</h4>Continuous surveillance of all cases of culture-confirmed TB in Canada. Demographic and microbiologic features were analyzed and comparisons between drug-susceptible, multidrug-resistant (MDR), and drug-resistant not-MDR were made. Cases of extensively drug resistant TB a ...[more]