scholarly journals Is Rapid Molecular Testing Enough In Screening Drug-Resistant Tuberculosis In Community?

2021 ◽  
Author(s):  
Ashok Dhaker ◽  
Ashish Bahal ◽  
Vishal Mangal ◽  
Arun K Yadav ◽  
Anuj Singhal ◽  
...  
Keyword(s):  
Sputum Sample ◽  
Nucleic Acid Amplification ◽  
Smear Microscopy ◽  
Molecular Testing ◽  
Drug Resistant ◽  
Second Line ◽  
First Line ◽  
Sensitivity Testing ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis

Background: The study aimed to compare the sensitivity and specificity of cartridge-based nucleic acid amplification test (CBNAAT) for diagnosis of Drug-Resistant Tuberculosis (DRTB) with culture sensitivity assays. Methods: Patients with cough symptoms for more than two weeks with any one symptom such as night sweats, fever, and unintentional weight loss were enrolled. Cases where Mycobacterium Tuberculosis was detected on sputum CBNAAT, were included in the study. Demographic variables, clinical features, and chest radiographs were collected. Each sputum sample was divided into three aliquots: smear microscopy, culture, and genotypic drug sensitivity testing (DST). Results of all three diagnostic modalities were compared with CBNAAT. Results: Out of 236 patients with sputum positive CBNAAT, 49.4 % (117/236) were rifampicin-resistant while 50. 6 % (119/236) were Rifampicin sensitive. The genotypic DST assays carried out on all enrolled patients showed that 76. 3 % (181/236) patients were resistant to one or more first-line or second-line antitubercular (ATT) drugs, while 23.7 % (55/236) patients were sensitive to all ATT drugs. On concordant analysis of CB NAAT with DST assays, we found that among 119 CB NAAT rifampicin sensitive patients, 66 patients were resistant to first-line or second-line antitubercular drugs. Conclusion: This study found that the screening of DRTB with CBNAAT at the community level is suboptimal compared to the gold standard. Although CBNAAT's sensitivity in detecting DRTB is significantly higher, the specificity is lower in that population who have received ATT earlier.

scholarly journals Prevalence of primary drug resistant tuberculosis in a tertiary care hospital, Nepal

2015 ◽  
Vol 4 (4) ◽  
pp. 36-38
Author(s):  
R Khunjeli ◽  
U R Mohsin ◽  
S K Shrestha ◽  
S Adhikari ◽  
B Srivastava ◽  
...  
Keyword(s):  
Armed Forces ◽  
Care Hospital ◽  
Drug Resistant ◽  
Newly Diagnosed ◽  
First Line ◽  
Sensitivity Testing ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Resistant Strains ◽  
Primary Drug

 Background & objectives: Tuberculosis is a transmissible disease mainly due to inhalation of infected droplet nuclei. The burden of drug resistant tuberculosis is very high in our neighboring countries India and China. Prevalence of primary drug resistant disease is difficult to estimate in our country because culture and sensitivity is not done routinely. This study was an attempt to find out the prevalence of drug resistant in newly diagnosed tuberculosis patients serving in the Nepalese Armed Forces. Methodology: Medical records of patients serving in the Nepalese Armed Forces who had the provisional diagnosis of pulmonary tuberculosis for the first time from July 2012 to June 2014 were analyzed. They had their sputum subjected for both smear and culture with sensitivity testing. Out of 134 patients, 62 had culture positive for Mycobacterium tuberculosis and drug sensitivity was done for the first line 4 antitubercular drugs. Results: Drug resistant strains were found in 5 cases (8.1%) of which 2 (3.2%) were resistant to 4 first line drugs - rifampicin, isoniazid, ethambutol and streptomycin. Prevalence of isoniazid resistance was the highest, found in 3 cases (4.8%). Conclusion: Primary drug resistant tuberculosis in newly diagnosed cases was high even in young healthy adults, and isoniazid resistant strains were the commonest.DOI: http://dx.doi.org/10.3126/jcmc.v4i4.11970

scholarly journals Status of antituberculosis drug resistance in Saudi Arabia 1979-98

2021 ◽  
Vol 8 (4-5) ◽  
pp. 664-670
Author(s):  
K. K. Abu Amero
Keyword(s):  
Saudi Arabia ◽  
Drug Sensitivity ◽  
National Policy ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
First Line ◽  
Sensitivity Testing ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis

All published material on the prevalence of drug-resistant tuberculosis within Saudi Arabia over the period 1979-98 was reviewed. The prevalence of single-drug-resistant tuberculosis ranged from 3.4% to 41% for isoniazid, 0% to 23.4% for rifampicin, 0.7% to 22.7% for streptomycin and 0% to 6.9% for ethambutol. The prevalence of multidrug-resistant tuberculosis [defined by WHO as resist1qance to two or more first-line antituberculosis drugs] ranged from 1.5% to 44% in different regions. No strong conclusions could be drawn owing to variations in the populations studied, geographical origins, site of Mycobacterium tuberculosis isolation [pulmonary or extrapulmonary] and drug sensitivity testing. However, the need to develop a standardized national policy for surveillance of drug-resistant tuberculosis in Saudi Arabia is clear

scholarly journals Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track?

2021 ◽  
Vol 18 (9) ◽  
pp. 4685
Author(s):  
Sharofiddin Yuldashev ◽  
Nargiza Parpieva ◽  
Salikhdjan Alimov ◽  
Laziz Turaev ◽  
Khasan Safaev ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Scale Up ◽  
Multidrug Resistant ◽  
Molecular Diagnostic ◽  
Drug Resistant ◽  
Second Line ◽  
First Line ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Mdr Tb

Uzbekistan has a large burden of drug-resistant tuberculosis (TB). To deal with this public health threat, the National TB Program introduced rapid molecular diagnostic tests such as Xpert MTB/RIF (Xpert) and line probe assays (LPAs) for first-line and second-line drugs. We documented the scale-up of Xpert and LPAs from 2012–2019 and assessed whether this led to an increase in patients with laboratory-confirmed multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB) and extensively drug-resistant TB (XDR-TB). This was a descriptive study using secondary program data. The numbers of GeneXpert instruments cumulatively increased from six to sixty-seven, resulting in annual assays increasing from 5574 to 107,330. A broader use of the technology resulted in a lower proportion of tests detecting Mycobacterium tuberculosis with half of the positive results showing rifampicin resistance. LPA instruments cumulatively increased from two to thirteen; the annual first-line assays for MDR-TB increased from 2582 to 6607 while second-line assays increased from 1435 in 2016 to 6815 in 2019 with about one quarter to one third of diagnosed patients showing second-line drug resistance. Patient numbers with laboratory-confirmed MDR-TB remained stable (from 1728 to 2060) but there was a large increase in patients with laboratory-confirmed XDR-TB (from 31 to 696). Programmatic implications and ways forward are discussed.

scholarly journals A population-based study of first and second-line drug-resistant tuberculosis in a high-burden area of the Mexico/United States border

2013 ◽  
Vol 108 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Pola Becerril-Montes ◽  
Salvador Said-Fernández ◽  
Julieta Luna-Herrera ◽  
Guillermo Caballero-Olín ◽  
José Antonio Enciso-Moreno ◽  
...  
Keyword(s):  
United States ◽  
Population Based ◽  
Drug Resistant ◽  
Second Line ◽  
Population Based Study ◽  
Drug Resistant Tuberculosis ◽  
High Burden ◽  
Resistant Tuberculosis ◽  
Line Drug

scholarly journals The Potential Impact of Up-Front Drug Sensitivity Testing on India’s Epidemic of Multi-Drug Resistant Tuberculosis

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0131438 ◽  
Author(s):  
Kuldeep Singh Sachdeva ◽  
Neeraj Raizada ◽  
Radhey Shyam Gupta ◽  
Sreenivas Achuthan Nair ◽  
Claudia Denkinger ◽  
...  
Keyword(s):  
Drug Sensitivity ◽  
Drug Resistant ◽  
Sensitivity Testing ◽  
Drug Resistant Tuberculosis ◽  
Drug Sensitivity Testing ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Potential Impact

scholarly journals SIDE EFFECTS ASSOCIATED WITH DRUGS USED IN TREATMENT OF MULTI DRUG RESISTANT TUBERCULOSIS AND TREATMENT RELATED FACTORS OF MULTI DRUG RESISTANT TUBERCULOSIS PATIENTS IN KATHMANDU VALLEY

2017 ◽  
Vol 14 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Chandra Prakash Bhatt ◽  
B KC
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Drug Resistant ◽  
Second Line ◽  
Related Factors ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Care Worker

Introduction: Treatment of multi drug resistant Mycobacterium tuberculosis (MDR-TB) with second line drugs is associated with adverse drug reactions and toxicity. Aim of this study were to determine side effects associated with drugs used in treatment of multi drug resistant tuberculosis and treatment related factors of MDR-TB patients.Methodology: A prospective study was carried out in National Tuberculosis Centre Bhaktapur Nepal. Questionnaires were used to collect data from patients.Results: Total 101 MDR TB patients were included among them majorities were male (52%) and mean age of the patients was 31.2 years. Majority of patients (87.1%) had previous history of tuberculosis treatment and 54.5% were in intensive phase of treatment. The side effect associated with drugs used in treatment of MDR-TB reported by patients were joint pain (21.2%), nausea (20.3%), hearing disturbances (11%), gastrointestinal disturbance (9.9%), depression (9.6%), itching (8.1%), hypothyroidism (6.4%), dizziness (6.4%), seizures (3.8%) and hepatitis (3.5%). Last month 25.74% patients missed one or more doses of drugs and 3.9% missed drug doses due to side effect of drugs. Majorities of the patients used vehicle to reach health centre (92.07%), time to reach the health center (59.4%) were less than 30 minutes but majorities of patients (57.4%) were not satisfied by the counseling of health care worker.Conclusion: The finding of this study shows that in MDR patients 12.8% were found new cases. Last month 3.9% patients were stopped the drugs due to side effects of drugs. Majority of patients (57.4%) were not satisfied by counseling of health care worker. Treatment of multi drug resistant tuberculosis with second line anti tubercular drugs is associated with side effects, health care worker counseling to MDR- TB patients with full attention is essential to encourage the patient’s moral and complete the treatment. Timely managing the side effects of medication is important in helping people to complete their treatment.SAARC J TUBER LUNG DIS HIV/AIDS, 2017; XIV(1), Page: 1-6

scholarly journals Treatment of Drug-Resistant Tuberculosis: Current Status

2020 ◽  
Author(s):  
Rajendra Prasad ◽  
Harsh Saxena ◽  
Nikhil Gupta ◽  
Mohammad Tanzeem ◽  
Ronal Naorem
Keyword(s):  
Total Duration ◽  
World Health ◽  
Current Status ◽  
Current Evidence ◽  
Drug Resistant ◽  
Second Line ◽  
Drug Resistant Tuberculosis ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Mdr Tb

AbstractDrug-resistant tuberculosis (DR-TB) has been an area of growing concern and posing threat to human health worldwide. The treatment has been defined for all types of DR-TB with or without newer anti-TB drugs. multi-DR-TB (MDR-TB) patients have now choice of two types of regimen, shorter and longer regimens. Shorter regimen for treatment of subset of MDR-TB patients who have not been previously treated with second line drugs and in whom resistance to fluoroquinolones and second-line injectable agents has been excluded is given for 9 to 11 months. A longer regimen of at least five effective anti-TB drugs (ATDs) during the intensive phase is recommended, including pyrazinamide and four core second-line ATDs. Intensive phase, including injectables, should be given for at least 8 months. The total duration of treatment is at least 20 months, which can be prolonged up to 24 months depending on the response of the patient. World Health Organization (WHO) has recently revised the grouping of ATD for use in DR-TB patients in 2018 into three groups based on individual patient data meta-analysis depending on their individual efficacy, risk of relapse, treatment failure, and death. Recently, an all oral longer regimen comprising bedaquiline, pretomanid, and linezolid (BPal regime) for 6 to 9 months for extensive-DR-TB (XDR-TB) patients and those MDR-TB patients who cannot tolerate or do not respond to conventional MDR-TB regimen. These new developments will be a step forward toward establishing universal regimen to treat all types of DR-TB. This article has summarized the current evidence from literature search to date, including prevalence of DR-TB, types of regimen used and the advancement in the regimens for effective treatment of DR-TB patients.

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