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Free Content Frequency and type of microbiological monitoring of multidrug-resistant tuberculosis treatment

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Monthly culture is usually recommended to monitor treatment of multidrug-resistant tuberculosis (MDR-TB). As mycobacterial laboratory capacity is limited in many settings, TB programs need evidence to decide whether monthly cultures are necessary compared to other approaches. We simulated three alternative monitoring strategies (culture every 2 or 3 months, and monthly smears alone) in a cohort of MDR-TB patients in Estonia, Latvia, Philippines, Russia and Peru from 2000 to 2004. This retrospective analysis illustrated that less frequent testing delays confirmation of bacteriological conversion. This would prolong intensive treatment, hospitalization and respiratory isolation, increasing cost and toxicity. After conversion, less frequent testing could delay diagnosis of possible treatment failure.
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Keywords: CULTURE CONVERSION; MDR-TB; MONITORING; TREATMENT RESPONSE

Document Type: Short Communication

Affiliations: 1: US Centers for Disease Control and Prevention, Atlanta, GA, USA 2: Partners In Health, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA 3: Partners In Health, Boston, Massachusetts, USA 4: Tartu University Lung Hospital, Tartu, Estonia; 5: World Health Organization, Geneva, Switzerland 6: Infectology Center of Latvia, TB and Lung Diseases Clinic, Riga, Latvia 7: Tropical Disease Foundation, Manila, The Philippines 8: National Institute for Health Development, Tallinn, Estonia

Publication date: November 1, 2011

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  • 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.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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