Display options
Cite
Rusovich V, Kumar AM, Skrahina A, et al. High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus. Public Health Action. 2014;4(4):243-8doi: 10.5588/pha.14.0069.
Rusovich, V., Kumar, A. M., Skrahina, A., Hurevich, H., Astrauko, A., de Colombani, P., Tayler-Smith, K., Dara, M., & Zachariah, R. (2014). High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus. Public health action, 4(4), 243-8. https://doi.org/10.5588/pha.14.0069
Rusovich, V, et al. "High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus." Public health action vol. 4,4 (2014): 243-8. doi: https://doi.org/10.5588/pha.14.0069
Rusovich V, Kumar AM, Skrahina A, Hurevich H, Astrauko A, de Colombani P, Tayler-Smith K, Dara M, Zachariah R. High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus. Public Health Action. 2014 Dec 21;4(4):243-8. doi: 10.5588/pha.14.0069. PMID: 26400703; PMCID: PMC4533518.
Copy Download .nbib Format: NLM
Share it on

Public Health Action. 2014 Dec 21;4(4):243-8. doi: 10.5588/pha.14.0069.

High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus.

Public health action

V Rusovich, A M V Kumar, A Skrahina, H Hurevich, A Astrauko, P de Colombani, K Tayler-Smith, M Dara, R Zachariah

Affiliations

  1. World Health Organization (WHO) Country Office, Minsk, Belarus.
  2. International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India.
  3. Republican Scientific and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus.
  4. WHO Regional Office for Europe, Copenhagen, Denmark.
  5. Médecins Sans Frontières (MSF), Operational Centre Brussels, MSF-Luxembourg, Luxembourg.

PMID: 26400703 PMCID: PMC4533518 DOI: 10.5588/pha.14.0069

Abstract

SETTING: Belarus (Eastern Europe) is facing an epidemic of multidrug-resistant tuberculosis (MDR-TB). In 2012, rapid molecular diagnostics were prioritised for sputum smear-positive pulmonary tuberculosis (PTB) patients to diagnose MDR-TB, while pulmonary sputum smear-negative pulmonary TB (SN-PTB) patients were investigated using conventional methods, often delaying the diagnosis of MDR-TB by 2-4 months.

OBJECTIVE: To determine the proportion of MDR-TB among SN-PTB patients registered in 2012 and associated clinical and demographic factors.

DESIGN: Retrospective cohort study using countrywide data from the national electronic TB register.

RESULTS: Of the 5377 TB cases registered, 2960 (55%) were SN-PTB. Of the latter, 1639 (55%) were culture-positive, of whom 768 (47%) had MDR-TB: 33% (363/1084) were new and 73% (405/555) previously treated patients. Previous history of treatment, age, region, urban residence, human immunodeficiency virus (HIV) status and being a pensioner were independently associated with MDR-TB.

CONCLUSION: About half of culture-positive SN-PTB patients have MDR-TB and this rises to over 7/10 for retreatment cases. A national policy decision to extend rapid molecular diagnostics universally to all PTB patients, including SN-PTB, seems justified. Steps need to be taken to ensure implementation of this urgent priority, given the patient and public health implications of delayed diagnosis.

Keywords: Eastern Europe; SORT IT; operational research

References

  1. Rev Esp Salud Publica. 2008 May-Jun;82(3):251-9 - PubMed
  2. Eur Respir J. 2012 Jun;39(6):1425-31 - PubMed
  3. N Engl J Med. 2010 Sep 9;363(11):1005-15 - PubMed
  4. Public Health Action. 2012 Mar 21;2(1):21-2 - PubMed
  5. Tuberculosis (Edinb). 2012 Sep;92(5):397-403 - PubMed
  6. J Infect Dis. 2007 Aug 15;196 Suppl 1:S86-107 - PubMed
  7. Bull World Health Organ. 2013 Jan 1;91(1):36-45 - PubMed
  8. J Clin Microbiol. 2013 Aug;51(8):2633-40 - PubMed
  9. Drug Resist Updat. 2013 Dec;16(6):108-15 - PubMed
  10. Tuberculosis (Edinb). 2015 Jun;95 Suppl 1:S212-6 - PubMed
  11. Int J Tuberc Lung Dis. 2011 Dec;15(12):1567-72 - PubMed
  12. Int J Tuberc Lung Dis. 2013 Jan;17(1):2 - PubMed
  13. J Clin Microbiol. 2006 Mar;44(3):811-8 - PubMed

Publication Types

Grant support