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Self-reported risks for multiple-drug resistance among new tuberculosis cases: Implications for drug susceptibility screening and treatment

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dc.contributor.author Brewer, T.F.
dc.contributor.author Choi, H.W.
dc.contributor.author Seas Ramos, Carlos Rafael
dc.contributor.author Krapp, F.
dc.contributor.author Zamudio Fuertes, Carlos Eduardo
dc.contributor.author Shah, L.
dc.contributor.author Ciampi, A.
dc.contributor.author Heymann, S.J.
dc.contributor.author Gotuzzo Herencia, José Eduardo
dc.date.accessioned 2022-01-18T19:34:38Z
dc.date.available 2022-01-18T19:34:38Z
dc.date.issued 2011
dc.identifier.uri https://hdl.handle.net/20.500.12866/11092
dc.description.abstract Background: Multiple drug-resistance in new tuberculosis (TB) cases accounts for the majority of all multiple drug-resistant TB (MDR-TB) worldwide. Effective control requires determining which new TB patients should be tested for MDR disease, yet the effectiveness of global screening recommendations of high-risk groups is unknown. Methods: Sixty MDR-TB cases with no history of previous TB treatment, 80 drug-sensitive TB and 80 community-based controls were recruited in Lima, Peru between August and December, 2008 to investigate whether recommended screening practices identify individuals presenting with MDR-TB. Odd ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression to study the association of potential risk factors with case/control variables. Results: MDR-TB cases did not differ from drug-sensitive TB and community controls in rates of human immunodeficiency virus infection, reported hospital or prison visits in the 3 years prior to diagnosis. MDR-TB cases were more likely than drug-sensitive TB controls to have had a recent MDR-TB household contact (OR 4.66, (95% CI 1.56-13.87)); however, only 15 cases (28.3%) reported this exposure. In multivariate modeling, recent TB household contact, but not contact with an MDR-TB case, remained predictive of MDR-TB, OR 7.47, (95% CI 1.91-29.3). Living with a partner rather than parents was associated with a lower risk of MDR-TB, OR 0.15, (95% CI 0.04-0.51). Conclusion: Targeted drug susceptibility testing (DST) linked to reported MDR-TB contact or other high-risk exposures does not identify the majority of new TB cases with MDR disease in Lima where it is endemic. All new TB cases should be screened with DST to identify MDR patients. These findings are likely applicable to other regions with endemic MDR-TB. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Case-Control Studies en_US
dc.subject Humans en_US
dc.subject Peru en_US
dc.subject Risk Factors en_US
dc.subject controlled study en_US
dc.subject major clinical study en_US
dc.subject endemic disease en_US
dc.subject mass screening en_US
dc.subject incidence en_US
dc.subject Human immunodeficiency virus infection en_US
dc.subject methodology en_US
dc.subject Human immunodeficiency virus en_US
dc.subject Multivariate Analysis en_US
dc.subject Incidence en_US
dc.subject household en_US
dc.subject lung tuberculosis en_US
dc.subject multidrug resistant tuberculosis en_US
dc.subject Tuberculosis, Multidrug-Resistant en_US
dc.subject microbiological examination en_US
dc.subject Microbial Sensitivity Tests en_US
dc.subject multidrug resistance en_US
dc.subject antibiotic sensitivity en_US
dc.subject Mass Screening en_US
dc.subject Drug Resistance, Multiple en_US
dc.subject hospital en_US
dc.subject prison en_US
dc.subject bacterial transmission en_US
dc.subject screening en_US
dc.subject Self Report en_US
dc.subject parent en_US
dc.subject drug susceptibility testing en_US
dc.subject miscellaneous named groups en_US
dc.subject partner en_US
dc.title Self-reported risks for multiple-drug resistance among new tuberculosis cases: Implications for drug susceptibility screening and treatment en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0025861
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.00
dc.relation.issn 1932-6203


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