Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Apr 25;8(4):e59903.
doi: 10.1371/journal.pone.0059903. Print 2013.

Linkage of presumptive multidrug resistant tuberculosis (MDR-TB) patients to diagnostic and treatment services in Cambodia

Sokhan Khann  1 , Eang Tan Mao, Yadav Prasad Rajendra, Srinath Satyanarayana, Sharath Burugina Nagaraja, Ajay M V Kumar
Affiliations

Linkage of presumptive multidrug resistant tuberculosis (MDR-TB) patients to diagnostic and treatment services in Cambodia

Sokhan Khann et al. PLoS One. .

Abstract

Setting: National Tuberculosis Programme, Cambodia.

Objective: In a cohort of TB patients, to ascertain the proportion of patients who fulfil the criteria for presumptive MDR-TB, assess whether they underwent investigation for MDR-TB, and the results of the culture and drug susceptibility testing (DST).

Methods: A cross sectional record review of TB patients registered for treatment between July-December 2011.

Results: Of 19,236 TB patients registered, 409 (2%) fulfilled the criteria of presumptive MDR-TB; of these, 187 (46%) were examined for culture. This proportion was higher among relapse, failure, return after default (RAD) and non-converters at 3 months of new smear positive TB patients (>60%) as compared to non-converters at 2 months of new TB cases (<20%). Nearly two thirds (n = 113) of the samples were culture positive; of these, three-fourth (n = 85) grew Mycobacterium tuberculosis complex (MTBc) and one-fourth (n = 28) grew non-tuberculous Mycobacteria. DST results were available for 96% of the MTBc isolates. Overall, 21 patients were diagnosed as MDR-TB (all diagnosed among retreatment TB cases and none from non-converters) and all of them were initiated on MDR-TB treatment.

Conclusion: There is a need to strengthen mechanisms for linking patients with presumptive MDR-TB to culture centers. The policy of testing non-converters for culture and DST needs to be reviewed.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Status of linking presumptive MDR-TB patients to diagnostic and MDR-TB treatment services in Cambodia (2011).
CC = Culture center, MTBc = Mycobacterium Tuberculosis complex, NTM = Non tuberculosis mycobacteria, DST = Drug Sensitivity Testing, MDR-TB = Multi drug resistant tuberculosis (resistant at R & H), PDR-TB = Poly drug resistant tuberculosis (resistant more than one but not R & H together), MonoDR-TB = Mono drug resistant tuberculosis.
See this image and copyright information in PMC

References

    1. Report WHO (2011) TUBERCULOSIS. Tuberculosis.
    1. Falzon D, Jaramillo E, Schünemann HJ, Arentz M, Bauer M, et al. (2011) WHO guidelines for the programmatic management of drug-resistant tuberculosis: 2011 update. The European respiratory journal?: official journal of the European Society for Clinical Respiratory Physiology 38: 516–528 Available: http://www.ncbi.nlm.nih.gov/pubmed/21828024. - PubMed
    1. Chadha SS, Sharath BN, Reddy K, Jaju J, Vishnu PH, et al. (2011) Operational challenges in diagnosing multi-drug resistant TB and initiating treatment in Andhra Pradesh, India. PloS one 6: e26659. Available: http://www.pubmedcentral.nih.gov/articlerender.fcgi? artid = 3206824&tool = pmcentrez&rendertype = abstract. Accessed 25 October 2012. - PMC - PubMed
    1. Falzon D, Jaramillo E, Schünemann HJ, Arentz M, Bauer M, et al. (2011) WHO guidelines for the programmatic management of drug-resistant tuberculosis: 2011 update. The European respiratory journal?: official journal of the European Society for Clinical Respiratory Physiology 38: 516–528 Available: http://www.ncbi.nlm.nih.gov/pubmed/21828024. - PubMed
    1. World Health Organization (2010)Treatment of Tuberculosis: guidelines. 4th ed. Geneva. WHO/HTM/TB/2009. - PubMed

Publication types

LinkOut - more resources