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Surveillance of drug-resistant tuberculosis in the state of Gujarat, India

Ramachandran, R and Nalini, S and Chandrasekaran, V and Dave, P V and Sanghvi, S and Wares, F and Paramasivan, C N and Narayanan, P R (2009) Surveillance of drug-resistant tuberculosis in the state of Gujarat, India. International Journal of Tuberculosis and Lung Disease, 13 (9). pp. 1154-1160. ISSN Print: 1027-3719; Online: 1815-7920

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Abstract

BACKGROUND: Limited information about the prevalence of drug-resistant tuberculosis (TB) has been reported from India, the country with the world’s highest burden of TB. We conducted a representative state-wide survey in the state of Gujarat (2005 population: 56 million). METHODS: Mycobacterium tuberculosis isolates from a representative sample of new and previously treated smear-positive pulmonary TB (PTB) cases were subjected to drug susceptibility testing (DST) against fi rst-line drugs at a World Health Organization supranational reference laboratory. Isolates found to have at least both isoniazid (INH) and rifampicin (RMP) resistance (i.e., multidrugresistant TB [MDR-TB]) were subjected to second-line DST. RESULTS: Of 1571 isolates from new patients, 1236 (78.7%) were susceptible to all fi rst-line drugs, 173 (11%) had any INH resistance and MDR-TB was found in 37 (2.4%, 95%CI 1.6–3.1). Of 1047 isolates from previously treated patients, 564 (54%) were susceptible to all fi rst-line drugs, 387 (37%) had any INH resistance and MDR-TB was found in 182 (17.4%, 95%CI 15.0–19.7%). Among 216 MDR-TB isolates, 52 (24%) were ofl oxacin (OFX) resistant; seven cases of extensively drug-resistant TB (XDR-TB) were found, all of whom were previously treated cases. CONCLUSION: MDR-TB prevalence remains low among new TB patients in Gujarat, but is more common among previously treated patients. Among MDR-TB isolates, the alarmingly high prevalence of OFX resistance may threaten the success of the expanding efforts to treat and control MDR-TB.

NIRT Creators:
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Item Type: Article
Uncontrolled Keywords: tuberculosis; drug resistance; India
Subjects: Tuberculosis > Epidemiological Research
Tuberculosis
Divisions: Clinical Research
Depositing User: Dr. Rathinasabapati R
Date Deposited: 20 Nov 2017 09:34
Last Modified: 20 Nov 2017 09:34
URI: http://eprints.nirt.res.in/id/eprint/971

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