Impact of scaling up Xpert ® MTB/RIF testing for the detection of rifampicin-resistant TB cases in Karachi, Pakistan
Document Type
Article
Department
Community Health Sciences
Abstract
Setting: Pakistan ranks fourth among the countries with a high burden of multidrug-resistant tuberculosis (MDR-TB), with only 19.2% of the 15 000 estimated incident cases being notified. Increasing treatment coverage for MDR-TB is a key priority for Pakistan's National Tuberculosis Programme. The World Health Organization recommends the use of the Xpert® MTB/RIF assay as the first-line diagnostic test for individuals with presumed TB.
Objective: To describe a multifaceted case-finding intervention targeting public and private sector health care facilities that used the Xpert assay as a frontline diagnostic test for individuals with presumptive TB, in Karachi, Pakistan, and its impact on case notifications of MDR-TB.
Design: Cross-sectional study.
Results: A total of 51 168 individuals were tested using Xpert, of whom respectively 7581 and 1534 people were diagnosed with TB in the public sector (reverse public-private mix) and private sector (social business model) arms; 574 (6.3% of all TB cases) were identified as having rifampicin (RMP) resistance. A total of 517 (90.1%) people with RMP-resistant TB (RR-TB) identified through the project were initiated on second-line treatment. The intervention resulted in 194 additional cases of RR-TB, an increase of 43% over the baseline.
Conclusion: This project, one of the largest Xpert testing programmes conducted at city level, resulted in significantly increased detection and treatment of MDR-TB.
Publication (Name of Journal)
The International Journal of Tuberculosis and Lung Disease
Recommended Citation
Awan, W. M.,
Zaidi, S. A.,
Habib, S. S.,
Khowaja, S.,
Malik, A.,
Khan, U.,
Ferrand, R. A.,
Creswell, J.,
Khan, A.
(2018). Impact of scaling up Xpert ® MTB/RIF testing for the detection of rifampicin-resistant TB cases in Karachi, Pakistan. The International Journal of Tuberculosis and Lung Disease, 22(8), 899-904.
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_chs_chs/942
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