Integration of HIV testing in tuberculosis drug resistance surveillance in Kazakhstan and Kenya [Short communication]

Klinkenberg, Eveline; S, van den Hof; Tursynbayeva, Aigul; Kipruto, Hillary; Wahogo, Josephine; Pak, Soojong; A, Kutwa; L'Herminez, R

doi:10.5588/ijtld.11.0262

Cited by 6 publications

(3 citation statements)

References 3 publications

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“…An earlier study evaluating completeness of DST results among culture-positive TB patients in Kazakhstan found that the rate of missing records decreased from 32.3% to 7.2% from March 2009 to March 2010 after regional TB centers were provided with monthly notifications to complete and correct data. [ 14 ] Our findings suggest that the completeness of records has reduced again, due to the introduction of a revised TB register, which does not have checks in place yet.…”

Section: Discussionmentioning

confidence: 92%

Effect of Introducing Xpert MTB/RIF to Test and Treat Individuals at Risk of Multidrug-Resistant Tuberculosis in Kazakhstan: A Prospective Cohort Study

Kampen

Tursynbayeva²,

Koptleuova³

et al. 2015

PLoS ONE

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BackgroundXpert MTB/RIF (Xpert) was piloted in Kazakhstan to detect tuberculosis (TB) and rifampicin resistance (RR-)TB among individuals at risk of multidrug-resistant (MDR-) TB. This study assessed the performance of Xpert compared to conventional diagnostic methods, RR-TB case detection among various risk groups, treatment initiation and time to diagnosis and treatment.MethodsEligible individuals were tested with Xpert, smear microscopy, culture and drug-susceptibility testing (DST) at the national TB reference laboratory and three provincial laboratories. Data was collected prospectively from August 2012 to May 2013 from routine laboratory and treatment registers.ResultsA total of 5,611 Xpert tests were performed mostly targeting contacts of MDR-TB patients, ‘other’ presumptive MDR-TB patients, and retreatment cases (26%, 24% and 22%, respectively). Compared to phenotypic DST, the positive predictive value of Xpert to detect RR-TB was 93.1% and 96.4% and the negative predictive value was 94.6% and 92.7% using solid and liquid culture media, respectively. RR-TB detection was highest among (former) prisoners, retreatment cases, people living with HIV/AIDS (PLWHA), and TB patients with positive smears after intensive phase of treatment (59%, 58%, 54% and 53% among TB positives, respectively). 88.9% of RR-TB patients were registered to have started second-line TB treatment. Median time to diagnosis with Xpert was 0.0 days (IQR 0.0-1.0), time from diagnosis to start of first-line treatment 3.0 days (IQR 1.0-7.0), and to start of second-line treatment 7.0 days (IQR 4.0-16).ConclusionsCompared to conventional culture and DST, Xpert had a shorter result turn-around-time and excellent concordance to detect RR-TB. Time from sputum collection to start of second-line treatment was reduced to one week. The yield of Xpert could be maximized by increasing referrals from penitentiary and HIV centers to TB centers.

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Section: Discussionmentioning

confidence: 92%

Effect of Introducing Xpert MTB/RIF to Test and Treat Individuals at Risk of Multidrug-Resistant Tuberculosis in Kazakhstan: A Prospective Cohort Study

Kampen

Tursynbayeva²,

Koptleuova³

et al. 2015

PLoS ONE

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“…Our survey found a prevalence of 1.8% MDR-TB among NSP which is lower than what was reported for Gujarat in 2007 (2.4%) [ 7 ]. The prevalence is lower than that reported from other high TB burden countries such as the former Soviet Union (ranged from 2.8% to 28.6%) [ 14 ], China (ranged from 3.8% to 14.7%) [ 15 , 16 ], and some low burden countries: Cameroon (6.67%) [ 17 ], Turkey (6.6%) [ 6 ] and Kenya (6.8%) [ 18 ]. All these surveys were done between 2008 and 2012 and appropriate guidelines were followed.…”

Section: Discussionmentioning

confidence: 74%

High Rates of Ofloxacin Resistance in Mycobacterium tuberculosis among Both New and Previously Treated Patients in Tamil Nadu, South India

et al. 2015

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Periodic drug resistance surveillance provides useful information on trends of drug resistance and effectiveness of tuberculosis (TB) control measures. The present study determines the prevalence of drug resistance among new sputum smear positive (NSP) and previously treated (PT) pulmonary TB patients, diagnosed at public sector designated microscopy centers (DMCs) in the state of Tamil Nadu, India. In this single-stage cluster-sampling prevalence survey, 70 of 700 DMCs were randomly selected using a probability-proportional to size method. A cluster size of 24 for NSP and a varying size of 0 to 99 for PT cases were fixed for each selected DMC. Culture and drug susceptibility testing was done on Lowenstein-Jensen medium using the economic variant of proportion sensitivity test for isoniazid (INH), rifampicin (RMP), ofloxacin (OFX) and kanamycin (KAN). Human Immunodeficiency Virus (HIV) status was collected from patient records. From June 2011 to August 2012, 1524 NSP and 901 PT patients were enrolled. Any RMP resistance and any INH resistance were observed in 2.6% and 15.1%, and in 10.4% and 30% respectively in NSP and PT cases. Among PT patients, multi drug resistant TB (MDR-TB) was highest in the treatment failure (35%) group, followed by relapse (13%) and treatment after default (10%) groups. Extensively drug resistant TB (XDRTB) was seen in 4.3% of MDR-TB cases. Any OFX resistance was seen in 10.4% of NSP, 13.9% of PT and 29% of PT MDR-TB patients. The HIV status of the patient had no impact on drug resistance levels. RMP resistance was present in 2.6% of new and 15.1% of previously treated patients in Tamil Nadu. Rates of OFX resistance were high among NSP and PT patients, especially among those with MDR-TB, a matter of concern for development of new treatment regimens for TB.

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“…More investments should be made in improving data capturing to include data on HIV co‐infection in MDR‐TB (Klinkenberg et al . ).…”

Section: Discussionmentioning

confidence: 97%

Multidrug‐resistant TB in Zambia: review of national data from 2000 to 2011

Kapata

Chanda‐Kapata

Bates

et al. 2013

Tropical Med Int Health

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Abstractbackground Multidrug-resistant tuberculosis (MDR-TB) is posing a great threat to global TB control. The burden in Zambia is not well defined because routine surveillance data are scarce. We reviewed national MDR-TB data for the last decade to inform future public health policy with respect to MDR-TB in Zambia.method Retrospective review of national surveillance of MDR-TB data, TB programme and laboratory reports between 2000 and 2011.results The total number of DSTs performed during this 11-year period was 2 038 and accounted for 2.6% (2 038/78 639) of all the retreatment cases notified. The total number of diagnosed MDR-TB cases for this period was 446, of which 56.3% (251/446) were male and 41.7% (186/446) female. Only one child was found to have MDR-TB. Poly-drug resistance accounted for 18.9% (172/ 911) of the DR-TB cases and 8.4% of the total DSTs. 8.8% (80/911) of the DR-TB cases showed either rifampicin mono-or poly-resistance other than MDR-TB. No XDR-TB was reported. There were no data available on DR-TB and HIV co-infection. Only 65 MDR-TB patients were notified and put on second-line treatment according to WHO guidelines.conclusions Multidrug-resistant tuberculosis may be an emerging challenge in Zambia. There is a need to invest in improving the capacity of the TB programme to detect and manage MDR-TB.

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Integration of HIV testing in tuberculosis drug resistance surveillance in Kazakhstan and Kenya [Short communication]

Cited by 6 publications

References 3 publications

Effect of Introducing Xpert MTB/RIF to Test and Treat Individuals at Risk of Multidrug-Resistant Tuberculosis in Kazakhstan: A Prospective Cohort Study

Effect of Introducing Xpert MTB/RIF to Test and Treat Individuals at Risk of Multidrug-Resistant Tuberculosis in Kazakhstan: A Prospective Cohort Study

High Rates of Ofloxacin Resistance in Mycobacterium tuberculosis among Both New and Previously Treated Patients in Tamil Nadu, South India

Multidrug‐resistant TB in Zambia: review of national data from 2000 to 2011

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