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Detection and management of drug-resistant tuberculosis in HIV-infected patients in lower-income countries

Ballif, M. and Nhandu, V. and Wood, R. and Dusingize, J. C. and Carter, E. J. and Cortes, C. P. and McGowan, C. C. and Diero, L. and Graber, C. and Renner, L. and Hawerlander, D. and Kiertiburanakul, S. and Du, Q. T. and Sterling, T. R. and Egger, M. and Fenner, L. and International epidemiological Databases to Evaluate Aids, . (2014) Detection and management of drug-resistant tuberculosis in HIV-infected patients in lower-income countries. The international journal of tuberculosis and lung disease, Vol. 18, H. 11. pp. 1327-1336.

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Official URL: http://edoc.unibas.ch/dok/A6308497

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Abstract

Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons.; To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries.; 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.; 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.; Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower-income countries. DOT was not always implemented and drug supplies were regularly interrupted, which may contribute to the global emergence of drug resistance.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medical Parasitology and Infection Biology > Tuberculosis Research (Gagneux)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Ballif, Marie and Fenner, Lukas
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:IUATLD
ISSN:1027-3719
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:07 Nov 2014 08:28
Deposited On:07 Nov 2014 08:28

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