title: Linkage of presumptive multidrug resistant tuberculosis (MDR-TB) patients to diagnostic and treatment services in Cambodia.
abstract: METHODS
  National Tuberculosis Programme, Cambodia.
  
  
  OBJECTIVE
  In a cohort of TB patients, to ascertain the proportion of patients who fulfil the criteria for presumptive MDR-TB, assess whether they underwent investigation for MDR-TB, and the results of the culture and drug susceptibility testing (DST).
  
  
  METHODS
  A cross sectional record review of TB patients registered for treatment between July-December 2011.
  
  
  RESULTS
  Of 19,236 TB patients registered, 409 (2%) fulfilled the criteria of presumptive MDR-TB; of these, 187 (46%) were examined for culture. This proportion was higher among relapse, failure, return after default (RAD) and non-converters at 3 months of new smear positive TB patients (>60%) as compared to non-converters at 2 months of new TB cases (<20%). Nearly two thirds (n = 113) of the samples were culture positive; of these, three-fourth (n = 85) grew Mycobacterium tuberculosis complex (MTBc) and one-fourth (n = 28) grew non-tuberculous Mycobacteria. DST results were available for 96% of the MTBc isolates. Overall, 21 patients were diagnosed as MDR-TB (all diagnosed among retreatment TB cases and none from non-converters) and all of them were initiated on MDR-TB treatment.
  
  
  CONCLUSIONS
  There is a need to strengthen mechanisms for linking patients with presumptive MDR-TB to culture centers. The policy of testing non-converters for culture and DST needs to be reviewed.
authors: Stop TB Department, World Health Organization, Phnom Penh, Cambodia. khannsokhan@yahoo.com
authors: Sokhan
authors: S
authors: Khann
authors: Eang Tan
authors: ET
authors: Mao
authors: Yadav Prasad
authors: YP
authors: Rajendra
authors: Srinath
authors: S
authors: Satyanarayana
authors: Sharath Burugina
authors: SB
authors: Nagaraja
authors: Ajay M V
authors: AM
authors: Kumar
mesh_terms: D002160:Cambodia; D003430:Cross-Sectional Studies; D046508:Culture Techniques; D003954:Diagnostic Services; D018432:Drug Resistance, Multiple; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*
references: Cochrane Database Syst Rev. 2013 Jan 31;(1):CD009593
references: 23440842
references: Eur Respir J. 2011 Sep;38(3):516-28
references: 21828024
references: Chin Med J (Engl). 2010 Jan 20;123(2):184-7
references: 20137367
references: PLoS One. 2011;6(11):e26659
references: 22073182
references: Int J Tuberc Lung Dis. 2011 Jan;15(1):137-9
references: 21276311