Identifying multidrug resistance in previously treated tuberculosis patients: a mixed-methods study in Cambodia
SETTING: Previously treated tuberculosis (TB) patients are a priority for drug susceptibility testing (DST) to identify cases with multidrug-resistant TB (MDR-TB). A Cambodia study found that one third of smear-positive previously treated patients had DST results.OBJECTIVE: To quantify the gaps in t...
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| Veröffentlicht in: | The international journal of tuberculosis and lung disease 2014-11, Vol.18 (11), p.1299-1306 |
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| container_title | The international journal of tuberculosis and lung disease |
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| creator | Royce, S. Khann, S. Yadav, R. P. Mao, E. T. Cattamanchi, A. Sam, S. Handley, M. A. |
| description | SETTING: Previously treated tuberculosis (TB) patients are a priority for drug susceptibility testing (DST) to identify cases with multidrug-resistant TB (MDR-TB). A Cambodia study found that one third of smear-positive previously treated patients had DST results.OBJECTIVE: To quantify
the gaps in the detection of MDR-TB in previously treated TB patients in Cambodia, and describe health workers' perspectives on barriers, facilitators and potential interventions.DESIGN: Analysis of Cambodia's 2004-2012 case notifications and semi-structured interviews with stakeholders.RESULTS:
The proportion of previously treated notifications varied significantly across provinces in 2010-2012. If there had been no attrition along the path to detecting MDR-TB among smear-positive notified cases in 2012, an estimated 75 additional MDR-TB cases could have been identified, which
would double the number actually detected. Most were lost due to misclassification of previously treated patients as 'new'. Barriers include patients' reluctance to disclose and staff difficulty in eliciting treatment history, partly attributed to the availability of streptomycin (SM)
only in hospitals. Facilitators include collection of sputum for DST even if previously treated patients are not receiving SM, streamlining sputum transportation and prompt reporting of results.CONCLUSION: Improved monitoring, supportive staff supervision and training, patient education,
and correct classification of previously treated cases are essential for improving the detection of MDR-TB. |
| doi_str_mv | 10.5588/ijtld.14.0116 |
| format | Article |
| fullrecord | <record><control><sourceid>pubtec_pubme</sourceid><recordid>TN_cdi_pubmed_primary_25299861</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ingid>iuatld/ijtld/2014/00000018/00000011/art00008</ingid><sourcerecordid>iuatld/ijtld/2014/00000018/00000011/art00008</sourcerecordid><originalsourceid>FETCH-LOGICAL-c530t-e38f066e03a70c4ba39addf142ebe6da0535d5c117eb7c822820535bc8ae6853</originalsourceid><addsrcrecordid>eNqNksuLFDEQxhtR3HX16FVyEbz0mMcknfYm464uLIiw91CdVI8Z-jHmsTj-9aZ3ZvQkmEuK8MtX1PdVVb1mdCWl1u_9Lg1uxdYryph6Ul0yzWTdtJw-LTXlTS0a1l5UL2LcUcoZY83z6oJL3rZasctqvnU4Jd8f_LQlYx6SdyFvScDoY4LJIvET2Qd88HOOw4GkgJDQkZQ7DDYPc-HIHpIvKvEDATL6n-jqEdP32UUSU3aHRWIDYzc7Dy-rZz0MEV-d7qvq_ub6fvOlvvv6-Xbz8a62UtBUo9A9VQqpgIbadQeiBed6tubYoXJApZBO2jINdo3VnGu-PHVWAyotxVX17ii7D_OPjDGZ0UeLwwATlkEMU6JtWyVF-x8oo43iQrGC1kfUhjnGgL3ZBz9COBhGzZKGeUzDsLVZ0ij8m5N07kZ0f-iz_QV4ewIgWhj6UBz38S-ntabrhhbu05ErKRWjwezmHKbin_EZlo7HvpwunR8P0-eCGQhpqXSR-fYvGXtWWnZmWRnzwPRUPvOyNFRzWYaS2jjsoSyJSRDM9peJWvwGD-bGZg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1610762361</pqid></control><display><type>article</type><title>Identifying multidrug resistance in previously treated tuberculosis patients: a mixed-methods study in Cambodia</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Royce, S. ; Khann, S. ; Yadav, R. P. ; Mao, E. T. ; Cattamanchi, A. ; Sam, S. ; Handley, M. A.</creator><creatorcontrib>Royce, S. ; Khann, S. ; Yadav, R. P. ; Mao, E. T. ; Cattamanchi, A. ; Sam, S. ; Handley, M. A.</creatorcontrib><description>SETTING: Previously treated tuberculosis (TB) patients are a priority for drug susceptibility testing (DST) to identify cases with multidrug-resistant TB (MDR-TB). A Cambodia study found that one third of smear-positive previously treated patients had DST results.OBJECTIVE: To quantify
the gaps in the detection of MDR-TB in previously treated TB patients in Cambodia, and describe health workers' perspectives on barriers, facilitators and potential interventions.DESIGN: Analysis of Cambodia's 2004-2012 case notifications and semi-structured interviews with stakeholders.RESULTS:
The proportion of previously treated notifications varied significantly across provinces in 2010-2012. If there had been no attrition along the path to detecting MDR-TB among smear-positive notified cases in 2012, an estimated 75 additional MDR-TB cases could have been identified, which
would double the number actually detected. Most were lost due to misclassification of previously treated patients as 'new'. Barriers include patients' reluctance to disclose and staff difficulty in eliciting treatment history, partly attributed to the availability of streptomycin (SM)
only in hospitals. Facilitators include collection of sputum for DST even if previously treated patients are not receiving SM, streamlining sputum transportation and prompt reporting of results.CONCLUSION: Improved monitoring, supportive staff supervision and training, patient education,
and correct classification of previously treated cases are essential for improving the detection of MDR-TB.</description><identifier>ISSN: 1027-3719</identifier><identifier>EISSN: 1815-7920</identifier><identifier>DOI: 10.5588/ijtld.14.0116</identifier><identifier>PMID: 25299861</identifier><language>eng</language><publisher>Paris: International Union Against Tuberculosis and Lung Disease</publisher><subject>Adult ; Antitubercular Agents - supply & distribution ; Antitubercular Agents - therapeutic use ; Bacterial diseases ; Biological and medical sciences ; Cambodia - epidemiology ; Diagnostic Pathway ; Drug Resistance, Multiple ; Female ; Human bacterial diseases ; Humans ; Implementation Science ; Infectious diseases ; Male ; Mdr-Tb Case Finding ; Medical sciences ; Middle Aged ; Mixed Methods ; Mycobacterium ; Mycobacterium tuberculosis - drug effects ; Mycobacterium tuberculosis - isolation & purification ; Pilot Projects ; Pneumology ; Qualitative Methods ; Sputum - microbiology ; Stakeholder Engagement ; Testing Coverage ; Tuberculosis and atypical mycobacterial infections ; Tuberculosis, Multidrug-Resistant - diagnosis ; Tuberculosis, Multidrug-Resistant - drug therapy ; Tuberculosis, Multidrug-Resistant - epidemiology</subject><ispartof>The international journal of tuberculosis and lung disease, 2014-11, Vol.18 (11), p.1299-1306</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c530t-e38f066e03a70c4ba39addf142ebe6da0535d5c117eb7c822820535bc8ae6853</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27928,27929</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28880470$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25299861$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Royce, S.</creatorcontrib><creatorcontrib>Khann, S.</creatorcontrib><creatorcontrib>Yadav, R. P.</creatorcontrib><creatorcontrib>Mao, E. T.</creatorcontrib><creatorcontrib>Cattamanchi, A.</creatorcontrib><creatorcontrib>Sam, S.</creatorcontrib><creatorcontrib>Handley, M. A.</creatorcontrib><title>Identifying multidrug resistance in previously treated tuberculosis patients: a mixed-methods study in Cambodia</title><title>The international journal of tuberculosis and lung disease</title><addtitle>Int J Tuberc Lung Dis</addtitle><description>SETTING: Previously treated tuberculosis (TB) patients are a priority for drug susceptibility testing (DST) to identify cases with multidrug-resistant TB (MDR-TB). A Cambodia study found that one third of smear-positive previously treated patients had DST results.OBJECTIVE: To quantify
the gaps in the detection of MDR-TB in previously treated TB patients in Cambodia, and describe health workers' perspectives on barriers, facilitators and potential interventions.DESIGN: Analysis of Cambodia's 2004-2012 case notifications and semi-structured interviews with stakeholders.RESULTS:
The proportion of previously treated notifications varied significantly across provinces in 2010-2012. If there had been no attrition along the path to detecting MDR-TB among smear-positive notified cases in 2012, an estimated 75 additional MDR-TB cases could have been identified, which
would double the number actually detected. Most were lost due to misclassification of previously treated patients as 'new'. Barriers include patients' reluctance to disclose and staff difficulty in eliciting treatment history, partly attributed to the availability of streptomycin (SM)
only in hospitals. Facilitators include collection of sputum for DST even if previously treated patients are not receiving SM, streamlining sputum transportation and prompt reporting of results.CONCLUSION: Improved monitoring, supportive staff supervision and training, patient education,
and correct classification of previously treated cases are essential for improving the detection of MDR-TB.</description><subject>Adult</subject><subject>Antitubercular Agents - supply & distribution</subject><subject>Antitubercular Agents - therapeutic use</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Cambodia - epidemiology</subject><subject>Diagnostic Pathway</subject><subject>Drug Resistance, Multiple</subject><subject>Female</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Implementation Science</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Mdr-Tb Case Finding</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mixed Methods</subject><subject>Mycobacterium</subject><subject>Mycobacterium tuberculosis - drug effects</subject><subject>Mycobacterium tuberculosis - isolation & purification</subject><subject>Pilot Projects</subject><subject>Pneumology</subject><subject>Qualitative Methods</subject><subject>Sputum - microbiology</subject><subject>Stakeholder Engagement</subject><subject>Testing Coverage</subject><subject>Tuberculosis and atypical mycobacterial infections</subject><subject>Tuberculosis, Multidrug-Resistant - diagnosis</subject><subject>Tuberculosis, Multidrug-Resistant - drug therapy</subject><subject>Tuberculosis, Multidrug-Resistant - epidemiology</subject><issn>1027-3719</issn><issn>1815-7920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNksuLFDEQxhtR3HX16FVyEbz0mMcknfYm464uLIiw91CdVI8Z-jHmsTj-9aZ3ZvQkmEuK8MtX1PdVVb1mdCWl1u_9Lg1uxdYryph6Ul0yzWTdtJw-LTXlTS0a1l5UL2LcUcoZY83z6oJL3rZasctqvnU4Jd8f_LQlYx6SdyFvScDoY4LJIvET2Qd88HOOw4GkgJDQkZQ7DDYPc-HIHpIvKvEDATL6n-jqEdP32UUSU3aHRWIDYzc7Dy-rZz0MEV-d7qvq_ub6fvOlvvv6-Xbz8a62UtBUo9A9VQqpgIbadQeiBed6tubYoXJApZBO2jINdo3VnGu-PHVWAyotxVX17ii7D_OPjDGZ0UeLwwATlkEMU6JtWyVF-x8oo43iQrGC1kfUhjnGgL3ZBz9COBhGzZKGeUzDsLVZ0ij8m5N07kZ0f-iz_QV4ewIgWhj6UBz38S-ntabrhhbu05ErKRWjwezmHKbin_EZlo7HvpwunR8P0-eCGQhpqXSR-fYvGXtWWnZmWRnzwPRUPvOyNFRzWYaS2jjsoSyJSRDM9peJWvwGD-bGZg</recordid><startdate>20141101</startdate><enddate>20141101</enddate><creator>Royce, S.</creator><creator>Khann, S.</creator><creator>Yadav, R. P.</creator><creator>Mao, E. T.</creator><creator>Cattamanchi, A.</creator><creator>Sam, S.</creator><creator>Handley, M. A.</creator><general>International Union Against Tuberculosis and Lung Disease</general><general>International Union against Tuberculosis and Lung Disease</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QL</scope><scope>C1K</scope></search><sort><creationdate>20141101</creationdate><title>Identifying multidrug resistance in previously treated tuberculosis patients: a mixed-methods study in Cambodia</title><author>Royce, S. ; Khann, S. ; Yadav, R. P. ; Mao, E. T. ; Cattamanchi, A. ; Sam, S. ; Handley, M. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c530t-e38f066e03a70c4ba39addf142ebe6da0535d5c117eb7c822820535bc8ae6853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Antitubercular Agents - supply & distribution</topic><topic>Antitubercular Agents - therapeutic use</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Cambodia - epidemiology</topic><topic>Diagnostic Pathway</topic><topic>Drug Resistance, Multiple</topic><topic>Female</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Implementation Science</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Mdr-Tb Case Finding</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mixed Methods</topic><topic>Mycobacterium</topic><topic>Mycobacterium tuberculosis - drug effects</topic><topic>Mycobacterium tuberculosis - isolation & purification</topic><topic>Pilot Projects</topic><topic>Pneumology</topic><topic>Qualitative Methods</topic><topic>Sputum - microbiology</topic><topic>Stakeholder Engagement</topic><topic>Testing Coverage</topic><topic>Tuberculosis and atypical mycobacterial infections</topic><topic>Tuberculosis, Multidrug-Resistant - diagnosis</topic><topic>Tuberculosis, Multidrug-Resistant - drug therapy</topic><topic>Tuberculosis, Multidrug-Resistant - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Royce, S.</creatorcontrib><creatorcontrib>Khann, S.</creatorcontrib><creatorcontrib>Yadav, R. P.</creatorcontrib><creatorcontrib>Mao, E. T.</creatorcontrib><creatorcontrib>Cattamanchi, A.</creatorcontrib><creatorcontrib>Sam, S.</creatorcontrib><creatorcontrib>Handley, M. A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>The international journal of tuberculosis and lung disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Royce, S.</au><au>Khann, S.</au><au>Yadav, R. P.</au><au>Mao, E. T.</au><au>Cattamanchi, A.</au><au>Sam, S.</au><au>Handley, M. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identifying multidrug resistance in previously treated tuberculosis patients: a mixed-methods study in Cambodia</atitle><jtitle>The international journal of tuberculosis and lung disease</jtitle><addtitle>Int J Tuberc Lung Dis</addtitle><date>2014-11-01</date><risdate>2014</risdate><volume>18</volume><issue>11</issue><spage>1299</spage><epage>1306</epage><pages>1299-1306</pages><issn>1027-3719</issn><eissn>1815-7920</eissn><abstract>SETTING: Previously treated tuberculosis (TB) patients are a priority for drug susceptibility testing (DST) to identify cases with multidrug-resistant TB (MDR-TB). A Cambodia study found that one third of smear-positive previously treated patients had DST results.OBJECTIVE: To quantify
the gaps in the detection of MDR-TB in previously treated TB patients in Cambodia, and describe health workers' perspectives on barriers, facilitators and potential interventions.DESIGN: Analysis of Cambodia's 2004-2012 case notifications and semi-structured interviews with stakeholders.RESULTS:
The proportion of previously treated notifications varied significantly across provinces in 2010-2012. If there had been no attrition along the path to detecting MDR-TB among smear-positive notified cases in 2012, an estimated 75 additional MDR-TB cases could have been identified, which
would double the number actually detected. Most were lost due to misclassification of previously treated patients as 'new'. Barriers include patients' reluctance to disclose and staff difficulty in eliciting treatment history, partly attributed to the availability of streptomycin (SM)
only in hospitals. Facilitators include collection of sputum for DST even if previously treated patients are not receiving SM, streamlining sputum transportation and prompt reporting of results.CONCLUSION: Improved monitoring, supportive staff supervision and training, patient education,
and correct classification of previously treated cases are essential for improving the detection of MDR-TB.</abstract><cop>Paris</cop><pub>International Union Against Tuberculosis and Lung Disease</pub><pmid>25299861</pmid><doi>10.5588/ijtld.14.0116</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1027-3719 |
| ispartof | The international journal of tuberculosis and lung disease, 2014-11, Vol.18 (11), p.1299-1306 |
| issn | 1027-3719 1815-7920 |
| language | eng |
| recordid | cdi_pubmed_primary_25299861 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Antitubercular Agents - supply & distribution Antitubercular Agents - therapeutic use Bacterial diseases Biological and medical sciences Cambodia - epidemiology Diagnostic Pathway Drug Resistance, Multiple Female Human bacterial diseases Humans Implementation Science Infectious diseases Male Mdr-Tb Case Finding Medical sciences Middle Aged Mixed Methods Mycobacterium Mycobacterium tuberculosis - drug effects Mycobacterium tuberculosis - isolation & purification Pilot Projects Pneumology Qualitative Methods Sputum - microbiology Stakeholder Engagement Testing Coverage Tuberculosis and atypical mycobacterial infections Tuberculosis, Multidrug-Resistant - diagnosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology |
| title | Identifying multidrug resistance in previously treated tuberculosis patients: a mixed-methods study in Cambodia |
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