title: Impact of introducing the line probe assay on time to treatment initiation of MDR-TB in Delhi, India.
abstract: METHODS
  National Institute of Tuberculosis and Respiratory Diseases (erstwhile Lala Ram Sarup Institute) in Delhi, India.
  
  
  OBJECTIVE
  To evaluate before and after the introduction of the line Probe Assay (LPA) a) the overall time to MDR-TB diagnosis and treatment initiation; b) the step-by-step time lapse at each stage of patient management; and c) the lost to follow-up rates.
  
  
  METHODS
  A retrospective cohort analysis was done using data on MDR-TB patients diagnosed during 2009-2012 under Revised National Tuberculosis Control Programme at the institute.
  
  
  RESULTS
  Following the introduction of the LPA in 2011, the overall median time from identification of patients suspected for MDR-TB to the initiation of treatment was reduced from 157 days (IQR 127-200) to 38 days (IQR 30-79). This reduction was attributed mainly to a lower diagnosis time at the laboratory. Lost to follow-up rates were also significantly reduced after introduction of the LPA (12% versus 39% pre-PLA).
  
  
  CONCLUSIONS
  Introduction of the LPA was associated with a major reduction in the delay between identification of patients suspected for MDR-TB and initiation of treatment, attributed mainly to a reduction in diagnostic time in the laboratory.
authors: National Institute of Tuberculosis & Respiratory Diseases, Delhi, India.
authors: Neeta
authors: N
authors: Singla
authors: International Union against Tuberculosis & Lung Disease, South-East Asia Regional Office, New Delhi, India.
authors: Srinath
authors: S
authors: Satyanarayana
authors: Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi, India.
authors: Kuldeep Singh
authors: KS
authors: Sachdeva
authors: Médecins Sans Frontières - Operational Centre Brussels, Operational Research Unit (LuxOR), Luxembourg.
authors: Rafael
authors: R
authors: Van den Bergh
authors: Médecins Sans Frontières - Operational Centre Brussels, Operational Research Unit (LuxOR), Luxembourg.
authors: Tony
authors: T
authors: Reid
authors: Médecins Sans Frontières - Operational Centre Brussels, Operational Research Unit (LuxOR), Luxembourg.
authors: Katherine
authors: K
authors: Tayler-Smith
authors: National Institute of Tuberculosis & Respiratory Diseases, Delhi, India.
authors: V P
authors: VP
authors: Myneedu
authors: Médecins Sans Frontières - Operational Centre Brussels, Operational Research Unit (LuxOR), Luxembourg.
authors: Engy
authors: E
authors: Ali
authors: International Union against Tuberculosis & Lung Disease, Paris, France.
authors: Donald A
authors: DA
authors: Enarson
authors: Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors: Digamber
authors: D
authors: Behera
authors: National Institute of Tuberculosis & Respiratory Diseases, Delhi, India.
authors: Rohit
authors: R
authors: Sarin
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001681:Biological Assay; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007194:India; D059012:Lost to Follow-Up; D008297:Male; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000502:physiology; D012189:Retrospective Studies; D061665:Time-to-Treatment; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents