Impact of rapid drug susceptibility testing for tuberculosis: Program experience in Lima, Peru

Sonya S. Shin, L. Asencios, M. Yagui, G. Yale, C. Suárez, J. Bayona, C. Bonilla, O. Jave, C. C. Contreras, S. Atwood, J. A. Blaya, J. Ershova, J. P. Cegielski

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

SETTING: Programmatic implementation of decentralized rapid drug susceptibility testing (DST) in Lima, Peru. OBJECTIVE: Pre-post analysis compared time to diagnosis, treatment outcome and survival among patients tested with direct nitrate reductase assay (NRA) vs. indirect conventional methods. DESIGN: From 2005 to 2009, we prospectively followed all patients referred for DST before (control) and after (intervention) NRA implementation. Among those referred for DST, NRA was used for smear-positive samples of patients with no prior history of multidrug resistance or treatment for multidrug-resistant tuberculosis (TB). Data were abstracted from patient charts and laboratory registers. Endpoints were favorable outcomes, time to result and time to death. RESULTS: Of those patients who met the criteria for NRA, 740 underwent NRA and 621 underwent conventional DST. NRA yielded test results for 78.4% of cases vs. 68.8% for conventional DST (P < 0.0001); the median time to result was 44 vs. 133 days, respectively (adjusted HR 0.64, 95%CI 0.56-0.73). Among individuals without previous anti-tuberculosis treatment, NRA was associated with a favorable treatment outcome (adjusted OR 1.39, 95%CI 1.01-1.90) and prolonged survival (adjusted HR 0.53, 95%CI 0.31-0.90). CONCLUSION: Direct NRA significantly shortened time to test result and improved treatment outcomes and survival in certain groups. © 2012 The Union.
Original languageAmerican English
Pages (from-to)1538-1543
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
DOIs
StatePublished - 1 Nov 2012

Fingerprint Dive into the research topics of 'Impact of rapid drug susceptibility testing for tuberculosis: Program experience in Lima, Peru'. Together they form a unique fingerprint.

  • Cite this

    Shin, S. S., Asencios, L., Yagui, M., Yale, G., Suárez, C., Bayona, J., Bonilla, C., Jave, O., Contreras, C. C., Atwood, S., Blaya, J. A., Ershova, J., & Cegielski, J. P. (2012). Impact of rapid drug susceptibility testing for tuberculosis: Program experience in Lima, Peru. International Journal of Tuberculosis and Lung Disease, 1538-1543. https://doi.org/10.5588/ijtld.12.0071