Multidrug-Resistant and Extensively Drug Resistant Tuberculosis in Kashmir, India

Datta, Bikram Singh; Hassan, Ghulam; Kadri, Syed Manzoor; Qasim, Waseem; Kamili, Mustadiq Ahmad; Singh, H B; Ahmad, Manzoor; Wani, Mushtaq Ahmad; Shamas-u-Din,; Thakur, Natasha

doi:10.3855/jidc.669

Cited by 48 publications

(32 citation statements)

References 12 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…treated PTB patients66724.12.34.22.11.53.2LJTertiary hospital (Armed forces)4Rai S P et al, 2007 [27]Ranchi2001–2004Newly diagnosed PTB patients76918.00.41.41.70.43.01.61.6LJTertiary hospital (Armed forces)5Jain A et al (a), 2008 [53]Lucknow2000–2002Combined PTB patients35337.42.00.30.66.019.329.011.0LJTertiary hospital6Jain A et al (b), 2008 [54]Lucknow2002–2004Combined PTB patients68638.229.720.717.827.719.825.513.2LJPrimary, Secondaryand Tertiary healthcare7Rawat J et al, 2009 [55]Dehradun2002–2006Prev. treated PTB patients18062.85.0057.257.2LJTertiary hospital8Datta B S et al, 2009 [56]Kashmir2003–2007Newly diagnosed PTB patients9105.70.9MGIT 960Primary, Secondaryand Tertiary healthcare9Mathuria J P et al (1), 2013 [38]Sawai Madhopur2004–2007Combined PTB patients4822.924.172.0814.5866.677.14LJDistrict...…”

Section: Resultsmentioning

confidence: 99%

Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

BackgroundDrug-resistant pulmonary tuberculosis (DR-TB) is a significant public health issue that considerably deters the ongoing TB control efforts in India. The purpose of this review was to investigate the prevalence of DR-TB and understand the regional variation in resistance pattern across India from 1995 to 2015, based on a large body of published epidemiological studies.MethodsA systematic review of published studies reporting prevalence of DR-TB from biomedical databases (PubMed and IndMed) was conducted. Meta-analysis was performed using random effects model and the pooled prevalence estimate (95% confidence interval [CI]) of DR-TB, multidrug resistant (MDR-) TB, pre-extensively drug-resistant (pre-XDR) TB and XDR-TB were calculated across two study periods (decade 1: 1995 to 2005; decade 2: 2006 to 2015), countrywide and in different regions. Heterogeneity in this meta-analysis was assessed using I2 statistic.ResultsA total of 75 of 635 screened studies that fulfilled the inclusion criteria were selected. Over 40% of 45,076 isolates suspected for resistance to any first-line anti-TB drugs tested positive. Comparative analysis revealed a worsening trend in DR-TB between the two study decades (decade 1: 37.7% [95% CI = 29.0; 46.4], n = 25 vs decade 2: 46.1% [95% CI = 39.0; 53.2], n = 36). The pooled estimate of MDR-TB resistance was higher in previously treated patients (decade 1: 29.8% [95% CI = 20.7; 39.0], n = 13; decade 2: 35.8% [95% CI = 29.2; 42.4], n = 24) as compared with the newly diagnosed cases (decade 1: 4.1% [95% CI = 2.7; 5.6], n = 13; decade 2: 5.6% [95% CI = 3.8; 7.4], n = 17). Overall, studies from Western states of India reported highest prevalence of DR-TB (57.8% [95% CI = 37.4; 78.2], n = 6) and MDR-TB (39.9% [95% CI = 21.7; 58.0], n = 6) during decade 2. Prevalence of pre-XDR TB was 7.9% (95% CI = 4.4; 11.4, n = 5) with resistance to fluoroquinolone (66.3% [95% CI = 58.2; 74.4], n = 5) being the highest. The prevalence of XDR-TB was 1.9% (95% CI = 1.2; 2.6, n = 14) over the 20-year period.ConclusionThe alarming increase in the trend of anti-TB drug resistance in India warrants the need for a structured nationwide surveillance to assist the National TB Control Program in strengthening treatment strategies for improved outcomes.

show abstract

Section: Resultsmentioning

confidence: 99%

Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

show abstract

“…2,4,5 However, earlier reports from Pune and Kashmir show a prevalence of 5.7%. 6,7 Thus, the prevalence of MDR-TB in different parts of India was observed at various magnitudes, which is also true globally.…”

Section: Discussionmentioning

confidence: 98%

Multi-drug-resistant tuberculosis: the experience of an urban tertiary care hospital in South India using automated BACTEC 460 TB

et al. 2011

View full text Add to dashboard Cite

The emergence of multi-drug-resistant (MDR) strains has been a major obstacle in the tuberculosis (TB) control programme. In the present study we looked into the prevalence of MDR-TB in an urban tertiary care hospital in South India over four years (2007-2010). During this period, 641 clinical specimens (317 respiratory specimens and 324 non-respiratory specimens) were received for mycobacteriological culture and drug susceptibility testing for first-line drugs, using the BACTEC 460 TB system. Mycobacterium tuberculosis (MTB) was isolated in 34.8% (n = 223) specimens. Of the total 223 MTB isolates 83 (37.2%) were MDR. Forty-two percent of the pulmonary MTB isolates (n = 72) and 20.4% of the extra-pulmonary isolates (n = 10) were MDR. Although we observed a high percentage of drug resistance, the prevalence of MDR was not observed to vary significantly within the four years which suggested good management.

show abstract

“…This high proportion of XDR isolates can be explained as these two reports are from tertiary care reference centres. Dutta et al from Kashmir in the year 2007 reported about 15.3% of the MDR-TB isolates in their study as extensively drug resistant [4].…”

Section: Discussionmentioning

confidence: 90%

“…India is also witnessing an increase in the number of MDR cases being reported from many parts of the country [3,4]. An updated report from WHO in 2013 estimated prevalence of 3.6% MDR tuberculosis in newly diagnosed cases and 20% in previously treated cases [5].…”

Section: Introductionmentioning

confidence: 99%

Study of drug resistance in pulmonary tuberculosis cases in south coastal Karnataka

Rao¹,

Chawla²,

Shenoy³

et al. 2015

JEGH

View full text Add to dashboard Cite

The present cross-sectional study was conducted for the first time from the Udupi district of coastal Karnataka to know the prevalence of drug resistance and comparative analysis of MDR and non-MDR cases of pulmonary tuberculosis. Details of 862 smear positive cases of pulmonary tuberculosis with age ⩾15 years from 12 designated microscopy centres of the Udupi district were studied. Initially 2 sputum samples trailed by one follow-up sample were collected from each patient and processed for culture and drug sensitivity on the Lowenstein-Jensen medium. A total resistance of 33.4% was observed that includes the mono-resistance of 22.5%, multidrug resistance (MDR) of 6.3% and extensive drug resistance (XDR) of 0.3%. Significant odds ratio (OR) was observed in category 2 cases (OR 3.9) for the development of MDR tuberculosis. A significant statistical association was observed using Fisher's exact test while comparing mortality rate (19.3% vs. 1.8%), treatment failure (8.8% vs. 3.8%) and cure rate (68.4% vs. 85.4%) between MDR and non-MDR cases (p<0.001). Category 2 patients are important risk factors for the development of MDR in pulmonary tuberculosis. Due to high mortality and low cure rate in MDR cases it is imperative to know the drug sensitivity report before institution of anti-tubercular treatment.

show abstract

Multidrug-Resistant and Extensively Drug Resistant Tuberculosis in Kashmir, India

Cited by 48 publications

References 12 publications

Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis

Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis

Multi-drug-resistant tuberculosis: the experience of an urban tertiary care hospital in South India using automated BACTEC 460 TB

Study of drug resistance in pulmonary tuberculosis cases in south coastal Karnataka

Contact Info

Product

Resources

About