Generic placeholder image

Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Research Article

Gaps in the Diagnosis and Treatment of Drug-resistant Tuberculosis in Mexico

Author(s): Rafael Laniado-Laborín*, Gerardo Castro-Mazon, Jorge Salcido-Gastélum, Nallely Saavedra-Herrera, Julio Magaña-Ocaña and Fátima Leticia Luna-López

Volume 20, Issue 1, 2024

Published on: 25 October, 2023

Page: [20 - 23] Pages: 4

DOI: 10.2174/011573398X261386231017190802

Price: $65

Abstract

Objective: The study aimed to determine the critical gaps in the care of drug-resistant tuberculosis to implement strategies for its elimination.

Material and Methods: Cases with various resistance profiles that were presented to the National Advisory Group for Drug Resistance during the years 2019-2022 have been described.

Results and Discussion: 104 cases were included in this study. 41% of the patients had diabetes (41%) as a comorbidity. There have been observed delays in the reporting of rapid molecular tests; with the Xpert MTB/RIF, delays of 6.33 days have been reported. There have also been observed delays in the request for phenotypic drug susceptibility tests; from the time of initial diagnosis, patients have been found to receive their first drug susceptibility test, on average, after 20 months. The bacteriological follow-up during the treatment with monthly culture has been found to only be carried out in 8% of the cases. In the contact investigation, only 16% of the listed contacts had been studied for infection or active disease.

Conclusion: The elimination of these gaps requires the decentralization of susceptibility tests for fluoroquinolones, shortening the times between the diagnosis of drug resistance and the start of treatment, a close clinical and bacteriological follow-up, and an exhaustive investigation of contacts.

[1]
Tiberi S, Utjesanovic N, Galvin J, et al. Drug resistant TB – latest developments in epidemiology, diagnostics and management. Int J Infect Dis 2022; 124 (Suppl. 1): S20-5.
[http://dx.doi.org/10.1016/j.ijid.2022.03.026] [PMID: 35342000]
[2]
Tuberculosis in the Americas Regional Report 2020. Washington, D.C.: Pan American Health Organization 2021.
[http://dx.doi.org/10.37774/9789275124475]
[3]
Manual of standardized procedures for the epidemiological surveillance of mycobacteriosis (tuberculosis and leprosy). Ministry of Health, Undersecretary of Prevention and Health Promotion. 2019.
[4]
Liebenberg D, Gordhan BG, Kana BD. Drug resistant tuberculosis: Implications for transmission, diagnosis, and disease management. Front Cell Infect Microbiol 2022; 12: 943545.
[http://dx.doi.org/10.3389/fcimb.2022.943545] [PMID: 36211964]
[5]
Villa-Rosas C, Laniado-Laborín R, Oceguera-Palao L. Primary drug resistance in a region with high burden of tuberculosis. A critical problem. Salud Publica Mex 2015; 57(2): 177-9.
[http://dx.doi.org/10.21149/spm.v57i2.7414] [PMID: 26235779]
[6]
WHO consolidated guidelines on tuberculosis Module 3: Diagnosis – rapid diagnostics for tuberculosis detection. Geneva: World Health Organization 2020.
[7]
Global tuberculosis programme. 2023. Available From: https://www.who.int/teams/global-tuberculosis-programme/data
[8]
WHO consolidated guidelines on tuberculosis Module 4: treatment - drug-resistant tuberculosis treatment. Geneva: World Health Organization 2020.
[9]
WHO consolidated guidelines on tuberculosis: Tuberculosis preventive treatment. Geneva: World Health Organization 2020.
[10]
Tegegne BS, Mengesha MM, Teferra AA, Awoke MA, Habtewold TD. Association between diabetes mellitus and multi-drug-resistant tuberculosis: Evidence from a systematic review and meta-analysis. Syst Rev 2018; 7(1): 161.
[http://dx.doi.org/10.1186/s13643-018-0828-0] [PMID: 30322409]
[11]
Huangfu P, Ugarte-Gil C, Golub J, Pearson F, Critchley J. The effects of diabetes on tuberculosis treatment outcomes: An updated systematic review and meta-analysis. Int J Tuberc Lung Dis 2019; 23(7): 783-96.
[http://dx.doi.org/10.5588/ijtld.18.0433] [PMID: 31439109]
[12]
Global tuberculosis report 2022. Geneva: World Health Organization 2022.
[13]
Implementing the end TB strategy: The essentials, 2022 update. Geneva: World Health Organization 2022.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy