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Volume 17, Number 3—March 2011

Research

Targeted Drug-Resistance Testing Strategy for Multidrug-Resistant Tuberculosis Detection, Lima, Peru, 2005–2008

Gustavo E. Velásquez, Martin Yagui, J. Peter Cegielski, Luis Asencios, Jaime Bayona, Cesar Bonilla, Hector O. Jave, Gloria Yale, Carmen Suárez, Sidney Atwood, Carmen C. Contreras, and Sonya S. ShinComments to Author 
Author affiliations: Author affiliations: Brigham and Women’s Hospital, Boston, Massachusetts, USA (G.E. Velásquez, S. Atwood, S.S. Shin); Instituto Nacional de Salud, Lima, Peru (M. Yagui, L. Asencios); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (J.P. Cegielski); Socios En Salud, Lima (J. Bayona, C.C. Conteras, S.S. Shin); Partners In Health, Boston (S.S. Shin); Dartmouth College, Hanover, New Hampshire, USA (J. Bayona); Ministerio de Salud del Perú, Lima (C. Bonilla, H.O. Jave); Dirección de Salud V Lima Ciudad, Lima (G. Yale); Dirección de Salud IV Lima Este, Lima (C. Suárez)

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Table 5

MDR TB among previously treated smear-positive TB patients compared with regional surveillance prevalence estimates, by NTP risk group, Lima, Peru, 2005–2008*

Risk factor Total no. patients No. (%)
MDR TB Odds ratio (95% CI)
Previously treated smear-positive TB patients in NTP regional surveillance data 104 25 (24.0)
Previously treated smear-positive TB patients in study cohort 583 210 (36.0) 1.78 (1.10–2.88)
HIV positive 36 12 (33.3) 1.58 (0.693.61)
Diabetes mellitus 30 10 (33.3) 1.58 (0.653.82)
Adverse reaction 13 1 (7.7) 0.26 (0.01–1.97)
Previous hospitalization within the past 2 y with duration >15 d 4 1 (25.0) 1.05 (0.02–13.80)
Health care worker during the past 2 y 4 1 (25.0) 1.05 (0.02–13.80)
Health sciences student during the past 2 y 4 3 (75.0) 9.48 (0.71–503.7)
Prisoner during the past 2 y 24 4 (16.7) 0.63 (0.20–2.02)
Adult case with household contact risk factor(s)† 109 56 (51.4) 3.34 (1.86–6.00)
Pediatric case with household contact risk factor(s)† 7 3 (42.9) 2.37 (0.32–14.92)
Private or self-administered treatment 87 28 (32.2) 1.50 (0.79–2.83)
Sputum positive during second or third month of category I treatment 5 3 (60.0) 4.74 (0.50–58.69)
Sputum positive during second or third month of category II treatment 13 11 (84.6) 17.38 (3.36–166.8)
Failure of category I treatment‡ 30 22 (73.3) 8.69 (3.44–21.93)
Relapsed within 6 mo after category I treatment§ 65 26 (40.0) 2.11 (1.08–4.12)
Defaulted while receiving category I treatment¶ 98 15 (15.3) 0.57 (0.28–1.16)
Failure of category II treatment‡ 18 11 (61.1) 4.97 (1.74–14.18)
Relapsed within 6 mo after category II treatment§ 8 5 (62.5) 5.27 (0.93–35.66)
Defaulted while receiving category II treatment¶ 63 16 (25.4) 1.08 (0.52–2.22)
Chronic treatment (>2 prior treatments)# 253 97 (38.3) 1.96 (1.17–3.29)

*MDR, multidrug resistant; TB, tuberculosis; CI, confidence interval; NTP, National Tuberculosis Control Program.
†Household contact risk factors are defined as household contact with a patient with known MDR TB, with a patient who showed TB treatment failure in the past 2 y, or with a patient being treated with second-line TB drugs.
‡Defined as positive smear and/or culture after >4 mo of treatment, or positive smear and/or culture upon finishing treatment.
§Defined as recurrence of disease <6 mo after being classified as cured by NTP norms.
¶Defined as not receiving treatment >1 mo upon enrollment into the study.
#Defined as a history of >2 previous TB treatments.

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