Rapid drug susceptibility testing and treatment outcomes for multidrug-resistant tuberculosis in Peru
OBJECTIVE: To evaluate the association between rapid DST use (nitrate reductase assay, microscopic observation drug susceptibility assay [MODS] and GenoType® MTBDRplus) and treatment outcomes and mortality in MDR-TB patients in Peru.
DESIGN: Retrospective cohort study of patients diagnosed with pulmonary MDR-TB between 2010 and 2013 (with treatment outcomes up to December 2015) using the electronic registry of the Peruvian National TB Programme.
RESULTS: A total of 2671 MDR-TB patients were included; the median age was 27 years, 2.8% were co-infected with the human immunodeficiency virus. Use of rapid DST was associated with a 40% increase in the adjusted odds of treatment success (aOR 1.40, 95%CI 1.19–1.64) and a 54% reduction in mortality (aOR 0.46, 95%CI 0.33–0.64). Higher treatment success rates were driven by MODS and GenoType® MTBDRplus testing (aORs for unsuccessful outcomes respectively 0.68 and 0.66).
CONCLUSION: The use of rapid DST (MODS and MTBDRplus) to diagnose MDR-TB was associated with a reduction in the odds of death and a substantial increase in the odds of treatment success.
Document Type: Research Article
Affiliations: 1: Instituto Nacional de Salud, Ministry of Health, Lima 2: Dirección de Prevención y Control de Tuberculosis, Ministry of Health, Lima 3: Universidad Peruana Cayetano Heredia, Lima 4: Hospital de Emergencia Villa El Salvador, Ministry of Health, Lima, Peru 5: Pan American Health Organization, Washington DC, USA 6: International Union Against Tuberculosis and Lung Disease, Oslo, Norway 7: Universidad Peruana Cayetano Heredia, Lima, London School of Hygiene & Tropical Medicine, London, UK
Publication date: November 1, 2018
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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