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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
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The California Multidrug-Resistant Tuberculosis Consult Service: a partnership of state and local programs
N S Shah1,2, J Westenhouse2, P Lowenthal2
1Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STI and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Public Health Action
|March 28, 2018
Summary
Expert consultations for multi-drug-resistant tuberculosis (MDR-TB) increased significantly. The California MDR-TB Service achieved high treatment success rates and positive management indicators for referred patients.
Area of Science:
- Public Health
- Infectious Diseases
- Tuberculosis Research
Background:
- US CDC recommends expert consultation for multi-drug-resistant tuberculosis (MDR-TB).
- California MDR-TB Service established in 2002 for expert consultations.
- Study describes patient characteristics, treatment outcomes, and management.
Purpose of the Study:
- To analyze the characteristics of MDR-TB patients referred for consultation.
- To evaluate treatment outcomes and management indicators for MDR-TB cases receiving expert consultation.
- To assess the trend in consultation uptake over time.
Main Methods:
- Descriptive analysis of surveillance data (July 2002-December 2012).
- Assessment of clinical consultation data and WHO indicators (January 2009-December 2012).
- Inclusion of pre-extensively drug-resistant TB and extensively drug-resistant TB cases.
Main Results:
- 140 out of 339 MDR-TB patients received consultation; consultation proportion rose from 12% to 63%.
- 88% of patients completed treatment; 86% had rapid molecular drug susceptibility testing.
- 98% received at least four effective drugs; 93% achieved culture conversion within 6 months.
Conclusions:
- Consultations with the MDR-TB Service showed a temporal increase.
- High treatment success rates and positive management indicators were observed.
- Expert consultation is a valuable component in MDR-TB management.
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