The Centers for Disease Control (CDC) is urging people with multidrug-resistant tuberculosis (MDR-TB) to receive proper treatment to prevent their condition from deteriorating into extensively drug-resistant tuberculosis (XDR-TB), whose sufferers could face life-long home quarantine or mandatory wearing of a face mask when outside.
The centers said MDR-TB is characterized by resistance to the two most powerful anti-TB drugs, isoniazid and rifampicin.
Patients who also have resistance to any of the fluoroquinolones (such as ofloxacin or moxifloxacin) and to at least one of three injectable second-line drugs (capreomycin, kanamycin and amikacin) are categorized as XDR-TB sufferers, the centers said.
XDR-TB is significantly harder to treat than MDR-TB and has a cure rate of less than 50 percent.
The CDC cited the case of a 27-year-old woman, nicknamed Niu Niu (妞妞), who was forced to drop out of school and enter house quarantine since she contracted the disease from her XDR-affected father a decade ago.
“Niu Niu fell between MDR and XDR when she was first diagnosed. For humanitarian reasons, she was allowed to go outside provided that she wore a hygiene mask,” said physician Huang Yi-wen (黃伊文), director of Changhua Hospital’s Pulmonary and Critical Care Center, who treated the woman.
However, in addition to facing problems pursuing an education and employment, Niu Niu has been subjected to mandatory hospital quarantine multiple times for breaking the face-mask rule, Huang said.
Niu Niu’s illness developed into XDR-TB after her father’s condition limited his ability to work, reducing the family’s income and limiting her access to proper treatment, the doctor said.
“There are four XDR-TB sufferers in the country who are still under treatment. Tuberculosis patients are generally less well-off and their financial problems often prevent them from getting much needed treatment, causing their condition to deteriorate over time,” Huang said.
However, Niu Niu has benefitted from the government’s introduction of new anti-tuberculosis drugs in recent years and a sputum smear in January came back negative, Huang said.
CDC Deputy Deputy Director-General Chuang Jen-hsiang (莊人祥) said Taiwan sees 12,000 new cases of tuberculosis each year, of whom 1 percent are diagnosed with MDR-TB.
“Although the recently introduced new anti-TB medications often come with strong side effects, they have given patients with XDR tuberculosis a chance to be cured and get rid of their face masks,” Chuang said.
CDC Director-General Steve Kuo (郭旭崧) said the Ministry of Health and Welfare has joined hands with welfare agencies to establish a platform to provide financial assistance to needy tuberculosis patients to boost their chance of receiving medical care.
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