ABSTRACT
INTRODUCTION: Extensively drug-resistant tuberculosis (XDR-TB) represents an emerging public health problem worldwide. According to the World Health Organization, an estimated 9.7% of multidrug-resistant TB (MDR-TB) cases are defined as XDR-TB globally. The objective of this study was to determine the prevalence of drug resistance to second-line TB drugs among MDR-TB cases detected in the Fourth National Anti-Tuberculosis Drug Resistance Survey in Viet Nam. METHODS: Eighty clusters of TB cases were selected using a probability-proportion-to-size approach. To identify MDR-TB cases, drug susceptibility testing (DST) was performed for the four major first-line TB drugs. DST of second-line drugs (ofloxacin, amikacin, kanamycin, capreomycin) was performed on isolates from MDR-TB cases to identify pre-XDR and XDR cases. RESULTS: A total of 1629 smear-positive TB cases were eligible for culture and DST. Of those, DST results for first-line drugs were available for 1312 cases, and 91 (6.9%) had MDR-TB. Second-line DST results were available for 84 of these cases. Of those, 15 cases (17.9%) had ofloxacin resistance and 6.0% were resistant to kanamycin and capreomycin. Five MDR-TB cases (6.0%) met the criteria of XDR-TB. CONCLUSION: This survey provides the first estimates of the proportion of XDR-TB among MDR-TB cases in Viet Nam and provides important information for local policies regarding second-line DST. Local policies and programmes that are geared towards TB prevention, early diagnosis and treatment with effective regimens are of high importance.
ABSTRACT
This paper has highlighted some key findings as follows: from 1991 - June 2007, there are 258 projects/programs in the health sector with the total amount of 1.543,07 million USD, in which the Ministry of Health directly manages 137 projects with a total amount of 1.114.93 million USD, accounting for 72.4% of the total ODA for the health sector. The grant aid funding accounts for 57%, loan accounts for 25.6% and mix aid modality account for 17.6%. ODA from bilateral agencies is 43%, from international banks account for 37% and from UN agencies is 20%. Grant aid is declining while the loan is on the rise. As compared with the government budget, ODA accounts for 12.09% -27.78% of government budget in different periods. Priority was given to preventive medicine areas rather than treatment areas. (31.8% compared with 24.5%), in which ODA for HIV/AIDS control is 27.8% in the total amount of ODA for preventive medicine. Some important area has not received anything due to the attention of donors, such as environmental health, tropical diseases control, non communicable diseases. ODA allocation is also not adequate in terms of regional distribution. Disadvantage areas received less than other regions.