Linkage of Presumptive Multidrug Resistant Tuberculosis (MDR-TB) Patients to Diagnostic and Treatment Services in Cambodia |
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Authors: | Sokhan Khann Eang Tan Mao Yadav Prasad Rajendra Srinath Satyanarayana Sharath Burugina Nagaraja Ajay M. V. Kumar |
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Affiliation: | 1. Stop TB Department, World Health Organization (WHO), Phnom Penh, Cambodia.; 2. National Tuberculosis Control Program, Ministry of Health, Phnom Penh, Cambodia.; 3. South-East Asia Office, International Union against Tuberculosis and Lung Disease (The Union), New Delhi, India.; 4. World Health Organization (WHO), New Delhi, India.; Institut de Pharmacologie et de Biologie Structurale, France, |
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Abstract: | SettingNational Tuberculosis Programme, Cambodia.ObjectiveIn a cohort of TB patients, to ascertain the proportion of patients who fulfil the criteria for presumptive MDR-TB, assess whether they underwent investigation for MDR-TB, and the results of the culture and drug susceptibility testing (DST).MethodsA cross sectional record review of TB patients registered for treatment between July-December 2011.ResultsOf 19,236 TB patients registered, 409 (2%) fulfilled the criteria of presumptive MDR-TB; of these, 187 (46%) were examined for culture. This proportion was higher among relapse, failure, return after default (RAD) and non-converters at 3 months of new smear positive TB patients (>60%) as compared to non-converters at 2 months of new TB cases (<20%). Nearly two thirds (n = 113) of the samples were culture positive; of these, three-fourth (n = 85) grew Mycobacterium tuberculosis complex (MTBc) and one-fourth (n = 28) grew non-tuberculous Mycobacteria. DST results were available for 96% of the MTBc isolates. Overall, 21 patients were diagnosed as MDR-TB (all diagnosed among retreatment TB cases and none from non-converters) and all of them were initiated on MDR-TB treatment.ConclusionThere is a need to strengthen mechanisms for linking patients with presumptive MDR-TB to culture centers. The policy of testing non-converters for culture and DST needs to be reviewed. |
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