A Sharma1, S Musau2, C M Heilig3, A O Okumu2, E O Opiyo2, F L Basiye4, F O Miruka4, J K Kioko5, J K Sitienei6, K P Cain7. 1. Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA. 2. Kenya Medical Research Institute, Kisian, Kenya. 3. Division of Tuberculosis Elimination, CDC, Atlanta, Georgia, USA. 4. Division of Global HIV/AIDS, CDC, Kisumu, Kenya. 5. Division of Tuberculosis and Lung Disease, Ministry of Health, Kenya. 6. Division of Communicable Disease Prevention and Control, Ministry of Health, Kenya. 7. Division of Tuberculosis Elimination, CDC, Kisumu, Kenya.
Abstract
SETTING: Drug susceptibility testing (DST) is recommended in Kenya to identify multidrug-resistant tuberculosis (MDR-TB) in persons registered for tuberculosis (TB) retreatment. DST is performed at a central laboratory with a two-step growth-based process and a regional laboratory with a simultaneous molecular- and growth-based process. OBJECTIVE: To compare proportions of retreatment cases who underwent DST and turnaround times for hospitals referring to the central vs. regional laboratory. DESIGN: Cases were persons registered for TB retreatment from 1 January 2012 to 31 December 2013. Records of 11 hospitals and 7 hospitals referring patients to the regional and central laboratories, respectively, were reviewed. RESULTS: Respectively 238/432 (55%) and 88/355 (25%) cases from hospitals referring to the regional and central laboratories underwent DST. The mean time from case registration to receipt of DST results and initiation of MDR-TB treatment was quicker in hospitals referring to the regional laboratory. The time required for the transportation of specimens, specimen testing and receipt of DST results at hospitals was shorter for the regional laboratory (P < 0.05). CONCLUSION: Testing was faster and more complete at hospitals referring to the regional laboratory. A comprehensive review of MDR-TB detection in Kenya is required to increase the proportion of cases receiving DST.
SETTING: Drug susceptibility testing (DST) is recommended in Kenya to identify multidrug-resistant tuberculosis (MDR-TB) in persons registered for tuberculosis (TB) retreatment. DST is performed at a central laboratory with a two-step growth-based process and a regional laboratory with a simultaneous molecular- and growth-based process. OBJECTIVE: To compare proportions of retreatment cases who underwent DST and turnaround times for hospitals referring to the central vs. regional laboratory. DESIGN: Cases were persons registered for TB retreatment from 1 January 2012 to 31 December 2013. Records of 11 hospitals and 7 hospitals referring patients to the regional and central laboratories, respectively, were reviewed. RESULTS: Respectively 238/432 (55%) and 88/355 (25%) cases from hospitals referring to the regional and central laboratories underwent DST. The mean time from case registration to receipt of DST results and initiation of MDR-TB treatment was quicker in hospitals referring to the regional laboratory. The time required for the transportation of specimens, specimen testing and receipt of DST results at hospitals was shorter for the regional laboratory (P < 0.05). CONCLUSION: Testing was faster and more complete at hospitals referring to the regional laboratory. A comprehensive review of MDR-TB detection in Kenya is required to increase the proportion of cases receiving DST.
Authors: Catharina C Boehme; Pamela Nabeta; Doris Hillemann; Mark P Nicol; Shubhada Shenai; Fiorella Krapp; Jenny Allen; Rasim Tahirli; Robert Blakemore; Roxana Rustomjee; Ana Milovic; Martin Jones; Sean M O'Brien; David H Persing; Sabine Ruesch-Gerdes; Eduardo Gotuzzo; Camilla Rodrigues; David Alland; Mark D Perkins Journal: N Engl J Med Date: 2010-09-01 Impact factor: 91.245
Authors: M A Espinal; K Laserson; M Camacho; Z Fusheng; S J Kim; R E Tlali; I Smith; P Suarez; M L Antunes; A G George; N Martin-Casabona; P Simelane; K Weyer; N Binkin; M C Raviglione Journal: Int J Tuberc Lung Dis Date: 2001-10 Impact factor: 2.373