S C Abeygunawardena1, B N Sharath2, R Van den Bergh3, B Naik4, N Pallewatte5, M N N Masaima6. 1. District Chest Clinic, Kalutara, Sri Lanka. 2. Employees' State Insurance Corporation Medical College & Postgraduate Institute of Medical Sciences and Research, Bangalore, India. 3. Médecins Sans Frontières, Brussels Operational Centre, MSF-Luxembourg, Luxembourg. 4. World Health Organization Country Office, New Delhi, India. 5. National Programme for Tuberculosis Control and Chest Disease, Colombo, Sri Lanka. 6. General Hospital, Kalutara, Sri Lanka.
Abstract
SETTING: District Chest Clinic, Kalutara, Sri Lanka. OBJECTIVES: To determine the coverage of culture and drug susceptibility testing (CDST), delays in CDST, treatment initiation, obtaining CDST results and treatment outcomes of previously treated tuberculosis (TB) patients. DESIGN: Retrospective cohort study involving review of records and reports. All previously treated TB patients from January 2008 to June 2013 were included in the study. RESULTS: Of 160 patients, 126 (79%) samples were sent for CDST; 79 (63%) were culture-positive and no multi-drug-resistant (MDR) TB cases were reported. Respectively 9% and 15% of patients experienced a delay in sending samples (median delay 21 days) and receiving CDST reports (median delay 71 days), while 20% experienced delays in initiating the retreatment regimen (median delay 11.5 days). The cohort recorded an 82% treatment success rate. CONCLUSION: Of all retreatment patients, only 79% were tested for CDST and there were sizeable delays in sample transportation and treatment initiation. Possible ways forward to strengthen the programme are discussed.
SETTING: District Chest Clinic, Kalutara, Sri Lanka. OBJECTIVES: To determine the coverage of culture and drug susceptibility testing (CDST), delays in CDST, treatment initiation, obtaining CDST results and treatment outcomes of previously treated tuberculosis (TB) patients. DESIGN: Retrospective cohort study involving review of records and reports. All previously treated TB patients from January 2008 to June 2013 were included in the study. RESULTS: Of 160 patients, 126 (79%) samples were sent for CDST; 79 (63%) were culture-positive and no multi-drug-resistant (MDR) TB cases were reported. Respectively 9% and 15% of patients experienced a delay in sending samples (median delay 21 days) and receiving CDST reports (median delay 71 days), while 20% experienced delays in initiating the retreatment regimen (median delay 11.5 days). The cohort recorded an 82% treatment success rate. CONCLUSION: Of all retreatment patients, only 79% were tested for CDST and there were sizeable delays in sample transportation and treatment initiation. Possible ways forward to strengthen the programme are discussed.
Entities:
Keywords:
culture and DST; operational delays; treatment outcome; tuberculosis
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