Please use this identifier to cite or link to this item:
http://ir.mu.ac.ke:8080/jspui/handle/123456789/3288
Title: | Detection and management of drug-resistant tuberculosis in HIV-infected patients in lower-income countries |
Authors: | Ballif, M. Nhandu, V. Wood, R. Dusingize, J. C. Carter, E. J. Cortes, C. P. McGowan, C. C. Diero, L. Graber, C. Renner, L. Hawerlander, D. Kiertiburanakul, S. Du, Q. T. Sterling, T. R. Egger, M. Fenner, L |
Keywords: | ART programs Africa Asia MDR-TB |
Issue Date: | 2014 |
Publisher: | International Union Against Tuberculosis and Lung Disease |
Abstract: | SETTING: Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons. OBJECTIVE: To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries. DESIGN: We used online questionnaires to collect program-level data on 47 ART programs in Southern Africa (n = 14), East Africa (n = 8), West Africa (n = 7), Central Africa (n = 5), Latin America (n = 7) and the Asia-Pacific (n = 6 programs) in 2012. Patient-level data were collected on 1002 adult TB patients seen at 40 of the participating ART programs. RESULTS: Phenotypic drug susceptibility testing (DST) was available in 36 (77%) ART programs, but was only used for 22% of all TB patients. Molecular DST was available in 33 (70%) programs and was used in 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the entire course of treatment, 16 (34%) during the intensive phase only, and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line anti-tuberculosis regimens; 18 (38%) reported TB drug shortages. CONCLUSIONS: Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower-income countries. DOT was not always implemented and drug supplies were regularly interrupted, which may contribute to the global emergence of drug resistance. |
URI: | https://doi.org/10.5588/ijtld.14.0106 http://ir.mu.ac.ke:8080/jspui/handle/123456789/3288 |
Appears in Collections: | School of Medicine |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.