Targeted Drug-Resistance Testing Strategy for Multidrug-Resistant Tuberculosis Detection, Lima, Peru, 2005–2008
2011

Targeted Testing for Multidrug-Resistant Tuberculosis in Peru

Sample size: 1241 publication 10 minutes Evidence: moderate

Author Information

Author(s): Velásquez Gustavo E., Yagui Martin, Cegielski J. Peter, Asencios Luis, Bayona Jaime, Bonilla Cesar, Jave Hector O., Yale Gloria, Suárez Carmen, Atwood Sidney, Contreras Carmen C., Shin Sonya S.

Primary Institution: Brigham and Women’s Hospital, Boston, Massachusetts, USA

Hypothesis

Can a targeted drug-resistance testing strategy effectively identify multidrug-resistant tuberculosis (MDR TB) in high-risk patients?

Conclusion

The targeted strategy effectively identified a higher proportion of MDR TB cases compared to national surveillance data.

Supporting Evidence

  • The proportion of MDR TB detected was higher than that from a concurrent national drug-resistance survey.
  • Among new smear-positive TB patients, household contact and suspected treatment failure were associated with MDR TB.
  • Among previously treated patients, multiple previous treatments and suspected treatment failure were linked to MDR TB.

Takeaway

This study looked at how well a special testing method found drug-resistant tuberculosis in patients in Peru. It showed that focusing on high-risk patients helped find more cases.

Methodology

Patients referred for culture and drug-susceptibility testing were monitored prospectively, and the effectiveness of a targeted testing strategy was evaluated.

Potential Biases

Frequent visits by data collectors may have influenced health care workers to adhere more closely to screening protocols.

Limitations

The study was observational and lacked a concurrent comparison group, which may affect the generalizability of the results.

Participant Demographics

The cohort included patients with suspected TB living in two districts of Lima, Peru, with a mix of new and previously treated cases.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3201/eid1703.101553

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