Tuberculosis Drug Resistance and HIV Infection, the Netherlands

In the Netherlands during 1993–2001, multidrug-resistant tuberculosis among newly diagnosed patients was more frequent in those with HIV coinfection (5/308, 1.6%) than in those with no HIV infection (39/646, 0.6%; adjusted odds ratio 3.43, p = 0.015). Four of the 5 patients coinfected with multidrug-resistant tuberculosis and HIV were foreign-born. DNA fingerprint analysis suggested that transmission had occurred outside the Netherlands

Diagnosis and Treatment of Tuberculosis in the Private Sector, Vietnam

To the Editor: In many countries, the private sector (practitioners not employed by government and nongovernment institutions, e.g., hospitals, pharmacies) is a major source of care, even for poor persons, and the area where services for the public are widely available (1,2). However, little information is available from high-incidence countries about the role of the private sector in tuberculosis (TB) detection and treatment (3). In Vietnam, ≤40% of all TB cases in Ho Chi Minh City (the largest city in Vietnam and with the highest rate of economic growth in the country) were estimated to be treated in the private sector (4), and half of all patients with a diagnosis of TB in the public sector (National Tuberculosis Program [NTP]) in Ho Chi Minh City initially sought help in the private sector (5). However, this estimate does not reflect private care in the entire countr

Tuberculosis Acquired Outside of Households, Rural Vietnam

Using population-based data from rural Vietnam, we assessed tuberculosis (TB) transmission within and outside of households. Eighty-three percent of persons with recent household TB were infected by different strains of Mycobacterium tuberculosis than were their household members. This result argues against the effectiveness of active TB case finding among household members

HIV and Tuberculosis in Ho Chi Minh City, Vietnam, 1997–2002

An emerging HIV epidemic, concentrated in young, male, injection drug users, is responsible for increasing TB reporting rates in urban Vietnam

Mycobacterium tuberculosis Genotype and Case Notification Rates, Rural Vietnam, 2003–2006

Tuberculosis case notification rates (CNRs) for young adults in Vietnam are increasing. To determine whether this finding could reflect emergence of Mycobacterium tuberculosis Beijing genotype, we studied all new sputum smear–positive pulmonary tuberculosis patients registered for treatment in 3 rural districts in Vietnam during 2003–2006. Beijing strain infections were more frequent in younger patients (15–24 years of age, 53%) than in older patients (31%; p65 years of age, respectively (p<0.001). These findings suggest that young adults may be responsible for introducing Beijing strains into rural Vietnam