Impact of scaling up Xpert® MTB/RIF testing for the detection of rifampicin-resistant TB cases in Karachi, Pakistan

SETTING: Pakistan ranks fourth among the countries with a high burden of multidrug-resistant tuberculosis (MDR-TB), with only 19.2% of the 15 000 estimated incident cases being notified. Increasing treatment coverage for MDR-TB is a key priority for Pakistan's National Tuberculosis Programme. T...

Full description

Saved in:

Bibliographic Details
Published in:	The international journal of tuberculosis and lung disease Vol. 22; no. 8; pp. 899 - 904
Main Authors:	Awan, W. M., Zaidi, S. M. A., Habib, S. S., Khowaja, S., Malik, A., Khan, U., Ferrand, R. A., Creswell, J., Khan, A.
Format:	Journal Article
Language:	English
Published:	France International Union Against Tuberculosis and Lung Disease 01-08-2018 International Union against Tuberculosis and Lung Disease (IUATLD)
Subjects:	Antibiotics, Antitubercular - therapeutic use Business Cross-Sectional Studies Diagnostic systems Diagnostic tests Drug Resistance, Bacterial Health care Humans Intervention Microbial Sensitivity Tests Multidrug resistance Multidrug resistant organisms Pakistan - epidemiology Private Sector Public Sector rifampicin resistance Rifampin Rifampin - therapeutic use Scaling Second-Line Treatment Tuberculosis Tuberculosis, Multidrug-Resistant - diagnosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology Pakistan Karachi Pakistan
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	SETTING: Pakistan ranks fourth among the countries with a high burden of multidrug-resistant tuberculosis (MDR-TB), with only 19.2% of the 15 000 estimated incident cases being notified. Increasing treatment coverage for MDR-TB is a key priority for Pakistan's National Tuberculosis Programme. The World Health Organization recommends the use of the Xpert® MTB/RIF assay as the first-line diagnostic test for individuals with presumed TB.OBJECTIVE: To describe a multifaceted case-finding intervention targeting public and private sector health care facilities that used the Xpert assay as a frontline diagnostic test for individuals with presumptive TB, in Karachi, Pakistan, and its impact on case notifications of MDR-TB.DESIGN: Cross-sectional study.RESULTS: A total of 51 168 individuals were tested using Xpert, of whom respectively 7581 and 1534 people were diagnosed with TB in the public sector (reverse public-private mix) and private sector (social business model) arms; 574 (6.3% of all TB cases) were identified as having rifampicin (RMP) resistance. A total of 517 (90.1%) people with RMP-resistant TB (RR-TB) identified through the project were initiated on second-line treatment. The intervention resulted in 194 additional cases of RR-TB, an increase of 43% over the baseline.CONCLUSION: This project, one of the largest Xpert testing programmes conducted at city level, resulted in significantly increased detection and treatment of MDR-TB.
Bibliography:	(R) Medicine - General 1027-3719(20180801)22:8L.899;1- ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1027-3719 1815-7920
DOI:	10.5588/ijtld.17.0729