Status of universal drug-susceptibility testing among sputum smear-positive tuberculosis patients diagnosed at a tertiary care centre

Indian J Med Res. 2023 Feb-Mar;157(2&3):216-219. doi: 10.4103/ijmr.IJMR_4148_20.

Abstract

Background & objectives: This study was aimed at estimating the proportion among sputum smear-positive tuberculosis (TB) patients diagnosed at a tertiary care centre in India, who did not undergo universal drug-susceptibility testing (UDST), assessing the sociodemographic and morbidity-related factors associated with it, ascertaining the reasons for not getting tested and estimating the proportion with any drug resistance (DR).

Methods: TB Notification Register and TB Laboratory Register, maintained in Designated Microscopy Centre and Intermediate Research Laboratory, respectively were used to obtain the patient details and information regarding UDST and DR-TB status. Under UDST, the TB patients had undergone rapid molecular tests to check for any DR. TB patients who dropped out of this strategy (those who did not submit a sputum sample for DR testing even after being instructed) were telephonically contacted and asked regarding reasons for not getting themselves tested.

Results: Of the 215 patients, 74 [34.4%, 95% confidence interval (CI): 28.1-41.2] did not undergo UDST. Of these 74 participants, 60 per cent reported the reason that they were not informed regarding the drug-susceptibility test. Among the 141 patients who underwent UDST, six (4.3%, 95% CI: 1.58-9.03) had DR. Non-UDST patients were significantly more in percentage among TB patients who were aged <30 years (adjusted prevalence ratio 2.36; 95% CI: 1.19-4.68) compared to >60 years.

Interpretation & conclusions: The present findings point towards a need to sensitize healthcare workers and TB patients to improve UDST.

Keywords: Cross-sectional studies; drug resistance; medical records; operational research; tuberculosis; universal drug-susceptibility testing.

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Humans
  • Mycobacterium tuberculosis*
  • Prevalence
  • Sputum
  • Tertiary Care Centers
  • Tuberculosis* / drug therapy
  • Tuberculosis, Multidrug-Resistant* / diagnosis
  • Tuberculosis, Multidrug-Resistant* / drug therapy
  • Tuberculosis, Multidrug-Resistant* / epidemiology

Substances

  • Antitubercular Agents