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Title: Detection and management of drug-resistant tuberculosis in HIV-infected patients in lower-income countries
Authors: M. Ballif
V. Nhandu
R. Wood
J. C. Dusingize
E. J. Carter
C. P. Cortes
C. C. McGowan
L. Diero
C. Graber
L. Renner
D. Hawerlander
S. Kiertiburanakul
Q. T. Du
T. R. Sterling
M. Egger
L. Fenner
S. Ajayi
K. Anastos
J. Bashi
W. Bishai
A. Boulle
P. Braitstein
G. Carriquiry
J. E. Carter
P. Cegielski
C. Chimbetete
J. Conrad
M. A. Davies
S. Duda
N. Durier
T. F. Eboua
A. Gasser
E. Geng
L. Hardwicke
C. Hoffmann
R. Huebner
N. Kancheya
P. Kim
D. Lameck
V. Leroy
C. Lewden
M. L. Lindegren
A. Mandalakas
M. Maskew
R. McKaig
L. Mofenson
M. Mpoudi-Etame
B. Okwara
S. Phiri
W. Prasitsuebsai
A. Petit
Hans Prozesky
S. E. Reid
G. Reubenson
A. Sohn
Q. Vo
D. Walker
F. Wehbe
C. Wejse
W. Wester
C. Williams
K. Wools-Kaloustian
Z. Yao
E. Yunihastuti
F. J. Zhang
H. X. Zhao
N. Han
T. P. Merati
D. N. Wirawan
Institut fur Sozial- und Praventivmedizin
Centre for Infectious Disease Research in Zambia
University of Cape Town
Women's Equity in Access to Care and Treatment
Academic Model Providing Access to Healthcare
Facultad de Medicina de la Universidad de Chile
Vanderbilt University
University of Ghana
Centre Intégré de Recherches Biocliniques
Mahidol University
Children's Hospital
Universitat Basel
Beijing Ditan Hospital
Universitas Udayana
The HIV Netherlands Australia Thailand Research Collaboration
TAHOD Steering Committee
Research Institute for Health Sciences
Bach Mai Hospital
National Hospital for Tropical Diseases
Foundation for AIDS Research
University of New South Wales (UNSW) Australia
TApHOD Steering Committee
Penang Hospital
Khon Kaen University
Albert Einstein College of Medicine of Yeshiva University
Newlands Clinic
Aurum Institute for Health Research
Lighthouse Trust
Tygerberg Hospital
Desmond Tutu HIV Centre
Centre National Hospitalier et Universitaire (CHNU)
Centre Intégré de Recherches Biocliniques d'Abidjan
Korle Bu Teaching Hospital
Bandim Health Project
Otu University
Operational and Statistical Team
Keywords: Medicine
Issue Date: 1-Nov-2014
Citation: International Journal of Tuberculosis and Lung Disease. Vol.18, No.11 (2014), 1327-1336
Abstract: © 2014 The Union. SETTING: Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons. OBJECTIVE: To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries. DESIGN: We used online questionnaires to collect program-level data on 47 ART programs in Southern Africa (n =14), East Africa (n = 8), West Africa (n = 7), Central Africa (n = 5), Latin America (n = 7) and the Asia-Pacific (n=6 programs) in 2012. Patient-level data were collected on 1002 adult TB patients seen at 40 of the participating ART programs. RESULTS: Phenotypic drug susceptibility testing (DST) was available in 36 (77%) ART programs, but was only used for 22% of all TB patients. Molecular DST was available in 33 (70%) programs and was used in 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the entire course of treatment, 16 (34%) during the intensive phase only, and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line anti-tuberculosis regimens; 18 (38%) reported TB drug shortages. CONCLUSIONS: Capacity to diagnose and treat drugresistant TB was limited across ART programs in lowerincome countries. DOT was not always implemented and drug supplies were regularly interrupted, which may contribute to the global emergence of drug resistance.
ISSN: 10273719
Appears in Collections:Scopus 2011-2015

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