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- Shifting Profile of MDR-TB Patients in Northern Portugal? [Letters to the Editor]Publication . Oliveira, Olena; Gaio, A.; Silva, Anabela; Macedo, Rita; Duarte, RaquelExtract: The occurrence of multidrug and extensively drug-resistant tuberculosis (M/XDR-TB), defined as a public health crisis by the World Health Organization (WHO) in 2013, is a threat to all efforts to control TB in Europe. Despite the steady decline of TB incidence, Europe has faced the largest proportion of M/XDR-TB among individuals diagnosed with TB; this requires a stronger link between health system strengthening and M/XDR-TB control to adequately prevent and treat this deadly disease. In 2014, 15% of new TB cases and 48% of previously treated cases were estimated to be MDR-TB.The XDR-TB prevalence among MDR-TB patients was 17.5 %. Within Europe the epidemiological pattern of TB varies greatly, with some countries showing a steady progress towards elimination of the disease, while others continue to face high rates of incidence. Portugal is the only Western European country presenting an intermediate TB incidence, estimated at 20 per 100 000 inhabitants in 2014, with the infection being concentrated at the two largest cities of Porto (Northern Region) and Lisbon (Lisbon and Tagus Valley Region). Nation wide, MDR-TB was reported for 2.5 % of the cases with drug-susceptibility testing (DST) results, 26% of which XDR. MDR-TB was substantially circumscribed to the metropolitan areas of Porto and Lisbon. In the Northern Region of Portugal, MDRTB was reported for 1.3 % of the cases with DST results without any diagnosed cases of XDR-TB. [...]