Characterising the treatment and prevention of drug resistant Tuberculosis in NSW

Multidrug-resistant tuberculosis (MDR-TB), defined by resistance to both isoniazid and rifampicin, has significant implications for individual patient management and poses a major barrier to TB control. Across Australia, around 30 people are diagnosed with MDR-TB each year, with many more individuals exposed during the pre-diagnostic phase. Management of MDR-TB is a major challenge for clinicians including the need for prolonged treatment, worse treatment outcomes, risk of treatment-related toxicity and increased cost of treatment for individuals and public health systems. In spite of the growing awareness of TB drug resistance, the essential variables necessary to fully understand MDR-TB and XDR-TB are currently not systematically collected, analysed and reported in published studies. A recent study identified discordance between current International standards of care and clinical practices in four countries of Europe. This highlighted the importance and need to evaluate practice and ensure the translation of policies into practice in order to optimise MDR-TB case management, prevention and control

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The first aim of this project is to evaluate the clinical management of patients with MDR-TB against international standards to optimise MDR-TB case management, prevention and control. The 2nd aim of the project will evaluate the screening and treatment of the contacts of patients with MDR-TB. The project will be carried out in hospitals within the NSW health as a retrospective cohort of patients from 2000-2016.