Management of previously treated tuberculosis patients in Kalutara district, Sri Lanka: how are we faring?
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.
Keywords: culture and DST; operational delays; treatment outcome; tuberculosis
Document Type: Research Article
Affiliations: 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
Publication date: 21 June 2014
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