M. BallifV. NhanduR. WoodJ. C. DusingizeE. J. CarterC. P. CortesC. C. McGowanL. DieroC. GraberL. RennerD. HawerlanderS. KiertiburanakulQ. T. DuT. R. SterlingM. EggerL. FennerS. AjayiK. AnastosJ. BashiW. BishaiA. BoulleP. BraitsteinG. CarriquiryJ. E. CarterP. CegielskiC. ChimbeteteJ. ConradM. A. DaviesS. DudaN. DurierT. F. EbouaA. GasserE. GengL. HardwickeC. HoffmannR. HuebnerN. KancheyaP. KimD. LameckV. LeroyC. LewdenM. L. LindegrenA. MandalakasM. MaskewR. McKaigL. MofensonM. Mpoudi-EtameB. OkwaraS. PhiriW. PrasitsuebsaiA. PetitHans ProzeskyS. E. ReidG. ReubensonA. SohnQ. VoD. WalkerF. WehbeC. WejseW. WesterC. WilliamsK. Wools-KaloustianZ. YaoE. YunihastutiF. J. ZhangH. X. ZhaoN. HanT. P. MeratiD. N. WirawanInstitut fur Sozial- und PraventivmedizinCentre for Infectious Disease Research in ZambiaUniversity of Cape TownWomen's Equity in Access to Care and TreatmentAcademic Model Providing Access to HealthcareFacultad de Medicina de la Universidad de ChileVanderbilt UniversityUniversity of GhanaCentre Intégré de Recherches BiocliniquesMahidol UniversityChildren's HospitalUniversitat BaselBeijing Ditan HospitalUniversitas UdayanaGokilaThe HIV Netherlands Australia Thailand Research CollaborationTAHOD Steering CommitteeResearch Institute for Health SciencesBach Mai HospitalNational Hospital for Tropical DiseasesFoundation for AIDS ResearchUniversity of New South Wales (UNSW) AustraliaTApHOD Steering CommitteePenang HospitalKhon Kaen UniversityTREAT AsiaAlbert Einstein College of Medicine of Yeshiva UniversityNewlands ClinicAurum Institute for Health ResearchLighthouse TrustTygerberg HospitalDesmond Tutu HIV CentreCentre National Hospitalier et Universitaire (CHNU)Centre Intégré de Recherches Biocliniques d'AbidjanKorle Bu Teaching HospitalBandim Health ProjectOtu UniversityOperational and Statistical Team2018-11-092018-11-092014-11-01International Journal of Tuberculosis and Lung Disease. Vol.18, No.11 (2014), 1327-1336102737192-s2.0-84908671644https://repository.li.mahidol.ac.th/handle/123456789/34177© 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.Mahidol UniversityMedicineArticleSCOPUS10.5588/ijtld.14.0106