title: Management of previously treated tuberculosis patients in Kalutara district, Sri Lanka: how are we faring?
abstract: METHODS
  District Chest Clinic, Kalutara, Sri Lanka.
  
  
  OBJECTIVE
  To determine the coverage of culture and drug susceptibility testing (CDST), delays in CDST, treatment initiation, obtaining CDST results and treatment outcomes of previously treated tuberculosis (TB) patients.
  
  
  METHODS
  Retrospective cohort study involving review of records and reports. All previously treated TB patients from January 2008 to June 2013 were included in the study.
  
  
  RESULTS
  Of 160 patients, 126 (79%) samples were sent for CDST; 79 (63%) were culture-positive and no multi-drug-resistant (MDR) TB cases were reported. Respectively 9% and 15% of patients experienced a delay in sending samples (median delay 21 days) and receiving CDST reports (median delay 71 days), while 20% experienced delays in initiating the retreatment regimen (median delay 11.5 days). The cohort recorded an 82% treatment success rate.
  
  
  CONCLUSIONS
  Of all retreatment patients, only 79% were tested for CDST and there were sizeable delays in sample transportation and treatment initiation. Possible ways forward to strengthen the programme are discussed.
authors.affiliation: District Chest Clinic, Kalutara, Sri Lanka.
authors.forename: S C
authors.initials: SC
authors.lastname: Abeygunawardena
authors.affiliation: Employees' State Insurance Corporation Medical College & Postgraduate Institute of Medical Sciences and Research, Bangalore, India.
authors.forename: B N
authors.initials: BN
authors.lastname: Sharath
authors.affiliation: Médecins Sans Frontières, Brussels Operational Centre, MSF-Luxembourg, Luxembourg.
authors.forename: R
authors.initials: R
authors.lastname: Van den Bergh
authors.affiliation: World Health Organization Country Office, New Delhi, India.
authors.forename: B
authors.initials: B
authors.lastname: Naik
authors.affiliation: National Programme for Tuberculosis Control and Chest Disease, Colombo, Sri Lanka.
authors.forename: N
authors.initials: N
authors.lastname: Pallewatte
authors.affiliation: General Hospital, Kalutara, Sri Lanka.
authors.forename: M N N
authors.initials: MN
authors.lastname: Masaima
keywords: culture and DST; operational delays; treatment outcome; tuberculosis