Impact of introducing the line probe assay on time to treatment initiation of MDR-TB in Delhi, India

PLoS One. 2014 Jul 24;9(7):e102989. doi: 10.1371/journal.pone.0102989. eCollection 2014.

Abstract

Setting: National Institute of Tuberculosis and Respiratory Diseases (erstwhile Lala Ram Sarup Institute) in Delhi, India.

Objectives: To evaluate before and after the introduction of the line Probe Assay (LPA) a) the overall time to MDR-TB diagnosis and treatment initiation; b) the step-by-step time lapse at each stage of patient management; and c) the lost to follow-up rates.

Methods: A retrospective cohort analysis was done using data on MDR-TB patients diagnosed during 2009-2012 under Revised National Tuberculosis Control Programme at the institute.

Results: Following the introduction of the LPA in 2011, the overall median time from identification of patients suspected for MDR-TB to the initiation of treatment was reduced from 157 days (IQR 127-200) to 38 days (IQR 30-79). This reduction was attributed mainly to a lower diagnosis time at the laboratory. Lost to follow-up rates were also significantly reduced after introduction of the LPA (12% versus 39% pre-PLA).

Conclusion: Introduction of the LPA was associated with a major reduction in the delay between identification of patients suspected for MDR-TB and initiation of treatment, attributed mainly to a reduction in diagnostic time in the laboratory.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use*
  • Biological Assay*
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Humans
  • India
  • Lost to Follow-Up
  • Male
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / physiology
  • Retrospective Studies
  • Time-to-Treatment*
  • Tuberculosis, Multidrug-Resistant / diagnosis*
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / microbiology
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / microbiology

Substances

  • Antitubercular Agents

Grants and funding

Funding for the course was from Bloomberg philanthropies, the Department for International Development, United Kingdom and Médecins Sans Frontières, Luxembourg. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.