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Assessing the Effect of Decentralization of Laboratory Diagnosis for Drug-resistant Tuberculosis in Kenya
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11 2015
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Source: Int J Tuberc Lung Dis. 19(11):1348-1353
[PDF-912.08 KB]
Details:
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Alternative Title:Int J Tuberc Lung Dis
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Personal Author:
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Description:Setting
Drug susceptibility testing (DST) is recommended in Kenya to identify multidrug-resistant tuberculosis (MDR-TB) in persons registered for retreatment of tuberculosis (TB). DST is performed at a central laboratory with a two-step growth-based process and a regional laboratory with a simultaneous molecular- and growth-based process.
Objective
To compare proportions of retreatment cases that underwent DST and turnaround times for hospitals referring to the central versus regional laboratory.
Design
Cases were persons registered for retreatment of TB during January 1, 2012 to December 31, 2013. Records were reviewed at 11 hospitals and 7 hospitals referring to the regional and central laboratories, respectively.
Results
Overall, 238/432 (55%) and 88/355 (25%) of cases at hospitals referring to the regional and central laboratories, respectively, underwent DST. The mean time from case registration to receipt of DST results and initiation of MDR-TB treatment was faster for hospitals referring to the regional laboratory. Specimen transport, specimen testing, and receipt of DST results at hospitals were shorter for the regional laboratory (p < 0.05).
Conclusion
Testing was faster and more complete at hospitals referring to the regional laboratory. The low proportions of cases receiving DST warrant a comprehensive review of detection of MDR-TB in Kenya.
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Pubmed ID:26467587
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Pubmed Central ID:PMC5017007
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Volume:19
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Issue:11
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