title: Use of Lot Quality Assurance Sampling to Ascertain Levels of Drug Resistant Tuberculosis in Western Kenya.
abstract: To classify the prevalence of multi-drug resistant tuberculosis (MDR-TB) in two different geographic settings in western Kenya using the Lot Quality Assurance Sampling (LQAS) methodology.
  
  
  
  The prevalence of drug resistance was classified among treatment-naïve smear positive TB patients in two settings, one rural and one urban. These regions were classified as having high or low prevalence of MDR-TB according to a static, two-way LQAS sampling plan selected to classify high resistance regions at greater than 5% resistance and low resistance regions at less than 1% resistance.
  
  
  
  This study classified both the urban and rural settings as having low levels of TB drug resistance. Out of the 105 patients screened in each setting, two patients were diagnosed with MDR-TB in the urban setting and one patient was diagnosed with MDR-TB in the rural setting. An additional 27 patients were diagnosed with a variety of mono- and poly- resistant strains.
  
  
  
  Further drug resistance surveillance using LQAS may help identify the levels and geographical distribution of drug resistance in Kenya and may have applications in other countries in the African Region facing similar resource constraints.
authors.affiliation: Stanford Medical School, Stanford, California, United States of Amercia.|Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Julia
authors.identifier: 0000-0003-2153-6464
authors.initials: J
authors.lastname: Jezmir
authors.affiliation: Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America.
authors.forename: Ted
authors.initials: T
authors.lastname: Cohen
authors.affiliation: Global TB Programme, TB Monitoring and Evaluation, World Health Organization, Geneva, Switzerland.
authors.forename: Matteo
authors.initials: M
authors.lastname: Zignol
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Edwin
authors.initials: E
authors.lastname: Nyakan
authors.affiliation: Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Bethany L
authors.initials: BL
authors.lastname: Hedt-Gauthier
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.|Indiana University School of Medicine, Indianapolis, Indiana, United States of America.
authors.forename: Adrian
authors.initials: A
authors.lastname: Gardner
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Lydia
authors.initials: L
authors.lastname: Kamle
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Wilfred
authors.initials: W
authors.lastname: Injera
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.|Alpert School of Medicine at Brown University, Providence, Rhode Island, United States of America.
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Carter
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D007630:Kenya / Q000453:epidemiology; D055810:Lot Quality Assurance Sampling / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000472:pathogenicity / Q000502:physiology; D015995:Prevalence; D012293:Rifampin / Q000627:therapeutic use; D012424:Rural Population; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014505:Urban Population
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin