Abstract
Settings: Kibong'oto Infectious Diseases Hospital, Kilimanjaro, Tanzania Objective: Characterise multidrug-resistant tuberculosis (MDR-TB)-treated cases during the scaling up of molecular diagnostics using Xpert MTB/RIF and GenoType MTBDRplus Design: Retrospective cohort study Results: A total of 223 MDR-TB patients were referred to the Kibong’oto Infectious Disease Hospital from January 2013 through December 2014. Four cities—Dar es Salaam, Mbeya, Mwanza, and Tanga—contributed 144 (65%) of referrals. Of the total referred patients, HIV coinfection was found in 92 (41%) and 180 (81%) had history of previous TB treatment. Molecular drug susceptibility testing (DST) contributed 201 (91%) of referrals and resulted in a shorter time from diagnosis to start of treatment, 30 days (95% confidence interval [CI], 26–37), compared to conventional phenotypic DST, 212 days (95% CI, 151–272; P
Highlights
Multidrug resistance to tuberculosis (MDR-TB) is defined as Mycobacterium tuberculosis (MTB) with at least resistance to isoniazid and rifampicin, and is associated with high morbidity and mortality.[1]
Molecular diagnostics appear to speedup the time to treatment initiation, but may not improve other treatment outcomes
Patients with previously treated MDR-TB and readmitted as failures or relapse or lost to follow-up were excluded. Those suspected of MDR-TB were screened in the domicile regions using molecular diagnostics (Xpert MTB/RIF or GenoType MTBDRplus),[8] or conventional drug-resistance surveillance performed programmatically at the Central TB Reference Laboratory (CTRL) in Dar es Salaam
Summary
Multidrug resistance to tuberculosis (MDR-TB) is defined as Mycobacterium tuberculosis (MTB) with at least resistance to isoniazid and rifampicin, and is associated with high morbidity and mortality.[1] Diagnosis of MDR-TB in resource-limited settings is immensely challenging, requiring identification of MTB and drug susceptibility testing (DST) to confirm, at minimum, isoniazid and rifampin resistance. East African Health Research Journal 2017 | Volume 1 | Number 1 as the 1% agar proportion, it requires mycobacterial culturing of sputum in biosafety facilities and takes upward of 12 weeks from the time the sputum specimen is submitted to produce results. Mutations in the drug resistance-conferring regions of the MTB genome have reasonable diagnostic accuracy, compared to phenotypic DST, for several important TB medications, including isoniazid and rifampin. The near immediacy of this faster testing approach has led to commercialised assays and a rather unprecedented global roll out.[2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
