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Antituberculosis Drug Resistance Survey in Lesotho, 2008-2009: Lessons Learned.

Maama-Maime LB, Mareka M, Ershova JV, Tlali TE, Kao K, Phalatse M, Polansky L, Beres LK, Letsie M, Holtz TH - PLoS ONE (2015)

Bottom Line: Among 2320 persons submitted sputum, 1164 (50.2%) were not asked for clinical information or did not have valid sputum samples for testing.Logistical, operational and data management challenges affected survey results.MDR-TB is prevalent in Lesotho, but limitations reduced the reliability of our findings.

View Article: PubMed Central - PubMed

Affiliation: National TB Programme, Ministry of Health, Maseru, Lesotho.

ABSTRACT

Setting: Drug resistance is an increasing threat to tuberculosis (TB) control worldwide. The World Health Organization advises monitoring for drug resistance, with either ongoing surveillance or periodic surveys.

Methods: The antituberculosis drug resistance survey was conducted in Lesotho in 2008-2009. Basic demographic and TB history information was collected from individuals with positive sputum smear results at 17 diagnostic facilities. Additional sputum sample was sent to the national TB reference laboratory for culture and drug susceptibility testing.

Results: Among 3441 eligible smear-positive persons, 1121 (32.6%) were not requested to submit sputum for culture. Among 2320 persons submitted sputum, 1164 (50.2%) were not asked for clinical information or did not have valid sputum samples for testing. In addition, 445/2320 (19.2%) were excluded from analysis because of other laboratory or data management reasons. Among 984/3441 (28.6%) persons who had data available for analysis, MDR-TB was present in 24/773 (3.1%) of new and 25/195 (12.8%) of retreatment TB cases. Logistical, operational and data management challenges affected survey results.

Conclusion: MDR-TB is prevalent in Lesotho, but limitations reduced the reliability of our findings. Multiple lessons learned during this survey can be applied to improve the next drug resistance survey in Lesotho and other resource constrained countries may learn how to avoid these bottlenecks.

No MeSH data available.


Related in: MedlinePlus

Lesotho Drug Resistance Survey (DRS) Sampling Flow Diagram.
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pone.0133808.g002: Lesotho Drug Resistance Survey (DRS) Sampling Flow Diagram.

Mentions: The national TB services registered 3441 smear-positive persons with pulmonary TB at 17 diagnostic centers during the survey period (June 2008–March 2009). Sputum specimens for culture were collected from 2320 (67.4%) persons (Fig 2). However, 1164 (50.2%) of the 2320 eligible persons who submitted sputum specimens for culture were excluded from the study for the following reasons: 142 (6.2%) had specimens that were discarded because of labeling errors, 131 (5.6%) had specimens that were contaminated, and 891 (38.4%) persons had no clinical information collected (Fig 2). The remaining 1156 (49.8%) persons had both sputum available for culture and demographic and clinical information available for analysis.


Antituberculosis Drug Resistance Survey in Lesotho, 2008-2009: Lessons Learned.

Maama-Maime LB, Mareka M, Ershova JV, Tlali TE, Kao K, Phalatse M, Polansky L, Beres LK, Letsie M, Holtz TH - PLoS ONE (2015)

Lesotho Drug Resistance Survey (DRS) Sampling Flow Diagram.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4514631&req=5

pone.0133808.g002: Lesotho Drug Resistance Survey (DRS) Sampling Flow Diagram.
Mentions: The national TB services registered 3441 smear-positive persons with pulmonary TB at 17 diagnostic centers during the survey period (June 2008–March 2009). Sputum specimens for culture were collected from 2320 (67.4%) persons (Fig 2). However, 1164 (50.2%) of the 2320 eligible persons who submitted sputum specimens for culture were excluded from the study for the following reasons: 142 (6.2%) had specimens that were discarded because of labeling errors, 131 (5.6%) had specimens that were contaminated, and 891 (38.4%) persons had no clinical information collected (Fig 2). The remaining 1156 (49.8%) persons had both sputum available for culture and demographic and clinical information available for analysis.

Bottom Line: Among 2320 persons submitted sputum, 1164 (50.2%) were not asked for clinical information or did not have valid sputum samples for testing.Logistical, operational and data management challenges affected survey results.MDR-TB is prevalent in Lesotho, but limitations reduced the reliability of our findings.

View Article: PubMed Central - PubMed

Affiliation: National TB Programme, Ministry of Health, Maseru, Lesotho.

ABSTRACT

Setting: Drug resistance is an increasing threat to tuberculosis (TB) control worldwide. The World Health Organization advises monitoring for drug resistance, with either ongoing surveillance or periodic surveys.

Methods: The antituberculosis drug resistance survey was conducted in Lesotho in 2008-2009. Basic demographic and TB history information was collected from individuals with positive sputum smear results at 17 diagnostic facilities. Additional sputum sample was sent to the national TB reference laboratory for culture and drug susceptibility testing.

Results: Among 3441 eligible smear-positive persons, 1121 (32.6%) were not requested to submit sputum for culture. Among 2320 persons submitted sputum, 1164 (50.2%) were not asked for clinical information or did not have valid sputum samples for testing. In addition, 445/2320 (19.2%) were excluded from analysis because of other laboratory or data management reasons. Among 984/3441 (28.6%) persons who had data available for analysis, MDR-TB was present in 24/773 (3.1%) of new and 25/195 (12.8%) of retreatment TB cases. Logistical, operational and data management challenges affected survey results.

Conclusion: MDR-TB is prevalent in Lesotho, but limitations reduced the reliability of our findings. Multiple lessons learned during this survey can be applied to improve the next drug resistance survey in Lesotho and other resource constrained countries may learn how to avoid these bottlenecks.

No MeSH data available.


Related in: MedlinePlus