Multidrug-resistant tuberculosis in the Northern Territory: A 10-year retrospective case series

Abstract

Background and objective: To describe the clinical characteristics, risk factors, diagnostic modalities, treatments, subsequent outcomes and complications of Multidrug-resistant tuberculosis (MDR-TB) cases residing in the Northern Territory.

Methods: A retrospective case series was conducted of all patients treated for MDR-TB in the Northern Territory between 1 January 2004 and 31 December 2013. This is the first study to analyse data relating to the subset of MDR-TB cases treated in the Northern Territory. Cases were identified by the Northern Territory Centre for Disease Control (NT CDC): the public health unit responsible for the management of tuberculosis in the Northern Territory. Outcome measures included patient demographics, diagnostics, HIV status, treatment methods, outcomes, and complications.

Results and conclusions: Six MDR-TB cases were treated in the Northern Territory; 5 of these were notified by the NT CDC during the study period (1.5% of all Northern Territory TB notifications). The median age of all 6 patients was 31 years (range 21 to 50 years), sex distribution was equal and all were born overseas. Country of birth in a World Health Organization (WHO) high burden MDR-TB country and previous treatment were most highly correlated with a current diagnosis of MDR-TB. Access to rapid drug susceptibility testing reduced the time to effective therapy from 45 to 27 days. Five patients met criteria for the WHO outcome term ‘treatment success’. The median length of treatment for the 5 patients treated in Australia was 623 days (537 to 730 days). Side effects to therapy were common and serious. The incidence of MDR-TB in the Northern Territory is similar to other Australian states. Rapid drug susceptibility testing reduces the time to effective therapy. Treatment regimens are complex, toxic and have serious resource implications for health care providers. Successful treatment outcomes are possible with coordinated TB control programs. Commun Dis Intell 2016;40(3):E334–E339.