Impact of infection control measures to control an outbreak of multidrug-resistant tuberculosis in a human immunodeficiency virus ward, Peru
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Multidrug-resistant tuberculosis (MDRTB) rates in a human immunodeficiency virus (HIV) care facility increased by the year 2000-56% of TB cases, eight times the national MDRTB rate. We reported the effect of tuberculosis infection control measures that were introduced in 2001 and that consisted of 1) building a respiratory isolation ward with mechanical ventilation, 2) triage segregation of patients, 3) relocation of waiting room to outdoors, 4) rapid sputum smear microscopy, and 5) culture/drug-susceptibility testing with the microscopic-observation drug-susceptibility assay. Records pertaining to patients attending the study site between 1997 and 2004 were reviewed. Six hundred and fifty five HIV/TB-coinfected patients (mean age 33 years, 79% male) who attended the service during the study period were included. After the intervention, MDRTB rates declined to 20% of TB cases by the year 2004 (P = 0.01). Extremely limited access to antiretroviral therapy and specific MDRTB therapy did not change during this period, and concurrently, national MDRTB prevalence increased, implying that the infection control measures caused the fall in MDRTB rates. The infection control measures were estimated to have cost US$91,031 while preventing 97 MDRTB cases, potentially saving US$1,430,026. Thus, this intervention significantly reduced MDRTB within an HIV care facility in this resource-constrained setting and should be cost-effective.
Date Issued
2016-09-12
Date Acceptance
2016-07-31
Citation
American Journal of Tropical Medicine and Hygiene, 2016, 95 (6), pp.1247-1256
ISSN
1476-1645
Publisher
American Society of Tropical Medicine and Hygiene
Start Page
1247
End Page
1256
Journal / Book Title
American Journal of Tropical Medicine and Hygiene
Volume
95
Issue
6
Copyright Statement
© The American Society of Tropical Medicine and Hygiene. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor
Sir Halley Stewart Trust
Wellcome Trust
Wellcome Trust
Medical Research Council (MRC)
Wellcome Trust
Wellcome Trust
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/27621303
PII: ajtmh.15-0712
Grant Number
103548/103356
070005/Z/02/Z
076340/Z/05/Z
MR/K007467/1
097816/Z/11/A
201251/Z/16/Z
Subjects
Tropical Medicine
11 Medical And Health Sciences
Publication Status
Published