Impact of Infection Control Measures to Control an Outbreak of Multidrug-Resistant Tuberculosis in a Human Immunodeficiency Virus Ward, Peru

Tovar, Marco A.; Gilman, Robert Hugh; Chumpitaz, Milagros; Kirwan, Daniela E.; Munayco, Cesar V.; Maguina, Monica; Escombe, Roderick; Evans, Carlton Anthony William; Ticona, Eduardo; Huaroto, Luz

dc.contributor.author	Ticona, Eduardo
dc.contributor.author	Huaroto, Luz
dc.contributor.author	Kirwan, Daniela E.
dc.contributor.author	Chumpitaz, Milagros
dc.contributor.author	Munayco, Cesar V.
dc.contributor.author	Maguina, Monica
dc.contributor.author	Tovar, Marco A.
dc.contributor.author	Evans, Carlton Anthony William
dc.contributor.author	Escombe, Roderick
dc.contributor.author	Gilman, Robert Hugh
dc.date.accessioned	2019-02-06T14:48:07Z
dc.date.available	2019-02-06T14:48:07Z
dc.date.issued	2016
dc.identifier.uri	https://hdl.handle.net/20.500.12866/5169
dc.description.abstract	Multidrug-resistant tuberculosis (MDRTB) rates in a human immunodeficiency virus (HIV) care facility increased by the year 2000-56% of TB cases, eight times the national MDRTB rate. We reported the effect of tuberculosis infection control measures that were introduced in 2001 and that consisted of 1) building a respiratory isolation ward with mechanical ventilation, 2) triage segregation of patients, 3) relocation of waiting room to outdoors, 4) rapid sputum smear microscopy, and 5) culture/drug-susceptibility testing with the microscopic-observation drug-susceptibility assay. Records pertaining to patients attending the study site between 1997 and 2004 were reviewed. Six hundred and fifty five HIV/TB-coinfected patients (mean age 33 years, 79% male) who attended the service during the study period were included. After the intervention, MDRTB rates declined to 20% of TB cases by the year 2004 (P = 0.01). Extremely limited access to antiretroviral therapy and specific MDRTB therapy did not change during this period, and concurrently, national MDRTB prevalence increased, implying that the infection control measures caused the fall in MDRTB rates. The infection control measures were estimated to have cost US$91,031 while preventing 97 MDRTB cases, potentially saving US$1,430,026. Thus, this intervention significantly reduced MDRTB within an HIV care facility in this resource-constrained setting and should be cost-effective.	en_US
dc.language.iso	eng
dc.publisher	American Society of Tropical Medicine and Hygiene
dc.relation.ispartofseries	American Journal of Tropical Medicine and Hygiene (ASTMH Journal)
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	Drug Resistance, Multiple, Bacterial	en_US
dc.subject	Antitubercular Agents/therapeutic use	en_US
dc.subject	Costs and Cost Analysis	en_US
dc.subject	HIV Infections/complications/epidemiology	en_US
dc.subject	Hospital Costs	en_US
dc.subject	Humans	en_US
dc.subject	Infection Control/economics/methods	en_US
dc.subject	Patient Isolation	en_US
dc.subject	Peru/epidemiology	en_US
dc.subject	Retrospective Studies	en_US
dc.subject	Tuberculosis, Multidrug-Resistant/epidemiology/prevention & control	en_US
dc.title	Impact of Infection Control Measures to Control an Outbreak of Multidrug-Resistant Tuberculosis in a Human Immunodeficiency Virus Ward, Peru	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.4269/ajtmh.15-0712
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn	1476-1645