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Volume 22, Number 3—March 2016

Decreased Time to Treatment Initiation for Multidrug-Resistant Tuberculosis Patients after Use of Xpert MTB/RIF Test, Latvia

Helen R. StaggComments to Author , Peter A. White, Vija Riekstiņa, Andra Cīrule, Ģirts Šķenders, Vaira Leimane1, Liga Kuksa1, Gunta Dravniece, James Brown, and Charlotte Jackson
Author affiliations: University College London, London, UK (H.R. Stagg, J. Brown, C. Jackson); Medical Research Council Centre for Outbreak Analysis and Modelling, London (P.J. White); National Institute for Health Research Health Protection Research Unit in Modelling Methodology, London (P.J. White); Imperial College School of Public Health, London (P.J. White); Public Health England, London (P.J. White); University of Latvia, Riga, Latvia (V. Riekstiņa); Riga East University Hospital, Riga (V. Riekstiņa, A. Cīrule, Ģ. Šķenders, V. Leimane, L. Kuksa); KNCV Tuberculosis Foundation, The Hague, the Netherlands (G. Dravniece); Royal Free London National Health Service Trust, London (J. Brown)

Main Article

Table 3

Stratified results for multivariable accelerated failure time model of association between Xpert MTB/RIF use and time to MDR TB treatment initiation for patients in MDR TB treatment cohorts, Latvia, 2009–2012*

Exposure Stratifier Multivariable regression, time ratio (95% CI) p value
Xpert MTB/RIF Previous TB
Not conducted No Baseline
Conducted, rifampin-resistant TB No 0.16 (0.12−0.21) <0.001
Not conducted Yes Baseline
Conducted, rifampin-resistant TB
0.34 (0.21–0.55)
Previous TB Xpert MTB/RIF
No Not conducted Baseline
Yes Not conducted 0.80 (0.62–1.04) 0.09
No Conducted, rifampin-resistant TB Baseline
Yes Conducted, rifampin-resistant TB 1.69 (1.03–2.76) 0.04

*Association between use of Xpert MTB/RIF and time to MDR TB treatment initiation was stratified by the effect modifier previous tuberculosis. Association between previous tuberculosis and time to MDR TB treatment initiation was stratified by Xpert use. There were 372 patients in the model. All results derived from the final model shown in Table 2. Median in baseline strata of Xpert MTB/RIF and previous tuberculosis was 41 days. MTB, Mycobacterium tuberculosis; RIF, rifampin. MDR TB, multidrug-resistant tuberculosis; NA, not applicable.

Main Article

1These authors contributed equally to this article.

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