Background

Unpredictable and ill-understood heterogeneity in all forms of tuberculosis clinical presentation and treatment response has been well-recognized for more than 50 years. Yet the determinants of this heterogeneity remain poorly understood, especially for MDR-TB.

Aims

This study will enable us to identify factors associated with MDR-TB treatment success and will significantly contribute to the evidence base for the development of MDR-TB treatment regimens in the MDR-TB management programme in Vietnam. In addition, they will increase our understanding of how host immune-factors influence disease resolution and outcome. These observational studies may form the foundation of future interventions to improve outcomes.

Objectives:

• To study the epidemiology of multi-drug resistant tuberculosis in Ho Chi Minh city for 5 years from 1/1/2011 to 31/12/2015.
• To study the host and bacterial determinants of outcome from multi-drug resistant pulmonary tuberculosis. Potential associated factors include host genetic variants, vitamin D deficiency, diabetes mellitus, peripheral blood CD8 T-cell exhaustion and bacterial population heterogeneity.

Study design

We will conduct a prospective observational study of 300 consecutive adult MDR-TB patients treated at 17 District TB Units (DTUs) and Pham Ngoc Thach Hospital. These 17 DTUs have treated the majority of MDR patients in Ho Chi Minh City. We anticipate participants will be recruited over 12 months, and each participant will be followed-up for 24 months from study entry.

We will also conduct a retrospective observational study of MDR tuberculosis from 1/1/2011-31/12/2015 in Ho Chi Minh City to characterize the epidemiology of MDR-TB in the last five years in HCMC, Viet Nam.