The Impact of a Line Probe Assay Based Diagnostic Algorithm on Time to Treatment Initiation and Treatment Outcomes for Multidrug Resistant TB Patients in Arkhangelsk Region, Russia.
Background In the Arkhangelsk region of Northern Russia, multidrug-resistant (MDR) tuberculosis (TB) rates in new cases are amongst the highest in the world. In 2014, MDR-TB rates reached 31.7% among new cases and 56.9% among retreatment cases. The development of new diagnostic tools allows for fast...
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ftdoajarticles:oai:doaj.org/article:72267107569445e4a08002411276157f 2023-05-15T15:23:50+02:00 The Impact of a Line Probe Assay Based Diagnostic Algorithm on Time to Treatment Initiation and Treatment Outcomes for Multidrug Resistant TB Patients in Arkhangelsk Region, Russia. Platon Eliseev Grigory Balantcev Elena Nikishova Anastasia Gaida Elena Bogdanova Donald Enarson Tara Ornstein Anne Detjen Russell Dacombe Elena Gospodarevskaya Patrick P J Phillips Gillian Mann Stephen Bertel Squire Andrei Mariandyshev 2016-01-01T00:00:00Z https://doi.org/10.1371/journal.pone.0152761 https://doaj.org/article/72267107569445e4a08002411276157f EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pone.0152761 https://doaj.org/toc/1932-6203 1932-6203 doi:10.1371/journal.pone.0152761 https://doaj.org/article/72267107569445e4a08002411276157f PLoS ONE, Vol 11, Iss 4, p e0152761 (2016) Medicine R Science Q article 2016 ftdoajarticles https://doi.org/10.1371/journal.pone.0152761 2022-12-31T11:43:53Z Background In the Arkhangelsk region of Northern Russia, multidrug-resistant (MDR) tuberculosis (TB) rates in new cases are amongst the highest in the world. In 2014, MDR-TB rates reached 31.7% among new cases and 56.9% among retreatment cases. The development of new diagnostic tools allows for faster detection of both TB and MDR-TB and should lead to reduced transmission by earlier initiation of anti-TB therapy. Study aim The PROVE-IT (Policy Relevant Outcomes from Validating Evidence on Impact) Russia study aimed to assess the impact of the implementation of line probe assay (LPA) as part of an LPA-based diagnostic algorithm for patients with presumptive MDR-TB focusing on time to treatment initiation with time from first-care seeking visit to the initiation of MDR-TB treatment rather than diagnostic accuracy as the primary outcome, and to assess treatment outcomes. We hypothesized that the implementation of LPA would result in faster time to treatment initiation and better treatment outcomes. Methods A culture-based diagnostic algorithm used prior to LPA implementation was compared to an LPA-based algorithm that replaced BacTAlert and Löwenstein Jensen (LJ) for drug sensitivity testing. A total of 295 MDR-TB patients were included in the study, 163 diagnosed with the culture-based algorithm, 132 with the LPA-based algorithm. Results Among smear positive patients, the implementation of the LPA-based algorithm was associated with a median decrease in time to MDR-TB treatment initiation of 50 and 66 days compared to the culture-based algorithm (BacTAlert and LJ respectively, p<0.001). In smear negative patients, the LPA-based algorithm was associated with a median decrease in time to MDR-TB treatment initiation of 78 days when compared to the culture-based algorithm (LJ, p<0.001). However, several weeks were still needed for treatment initiation in LPA-based algorithm, 24 days in smear positive, and 62 days in smear negative patients. Overall treatment outcomes were better in LPA-based algorithm compared ... Article in Journal/Newspaper Arkhangelsk Directory of Open Access Journals: DOAJ Articles PLOS ONE 11 4 e0152761 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
topic |
Medicine R Science Q |
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Medicine R Science Q Platon Eliseev Grigory Balantcev Elena Nikishova Anastasia Gaida Elena Bogdanova Donald Enarson Tara Ornstein Anne Detjen Russell Dacombe Elena Gospodarevskaya Patrick P J Phillips Gillian Mann Stephen Bertel Squire Andrei Mariandyshev The Impact of a Line Probe Assay Based Diagnostic Algorithm on Time to Treatment Initiation and Treatment Outcomes for Multidrug Resistant TB Patients in Arkhangelsk Region, Russia. |
topic_facet |
Medicine R Science Q |
description |
Background In the Arkhangelsk region of Northern Russia, multidrug-resistant (MDR) tuberculosis (TB) rates in new cases are amongst the highest in the world. In 2014, MDR-TB rates reached 31.7% among new cases and 56.9% among retreatment cases. The development of new diagnostic tools allows for faster detection of both TB and MDR-TB and should lead to reduced transmission by earlier initiation of anti-TB therapy. Study aim The PROVE-IT (Policy Relevant Outcomes from Validating Evidence on Impact) Russia study aimed to assess the impact of the implementation of line probe assay (LPA) as part of an LPA-based diagnostic algorithm for patients with presumptive MDR-TB focusing on time to treatment initiation with time from first-care seeking visit to the initiation of MDR-TB treatment rather than diagnostic accuracy as the primary outcome, and to assess treatment outcomes. We hypothesized that the implementation of LPA would result in faster time to treatment initiation and better treatment outcomes. Methods A culture-based diagnostic algorithm used prior to LPA implementation was compared to an LPA-based algorithm that replaced BacTAlert and Löwenstein Jensen (LJ) for drug sensitivity testing. A total of 295 MDR-TB patients were included in the study, 163 diagnosed with the culture-based algorithm, 132 with the LPA-based algorithm. Results Among smear positive patients, the implementation of the LPA-based algorithm was associated with a median decrease in time to MDR-TB treatment initiation of 50 and 66 days compared to the culture-based algorithm (BacTAlert and LJ respectively, p<0.001). In smear negative patients, the LPA-based algorithm was associated with a median decrease in time to MDR-TB treatment initiation of 78 days when compared to the culture-based algorithm (LJ, p<0.001). However, several weeks were still needed for treatment initiation in LPA-based algorithm, 24 days in smear positive, and 62 days in smear negative patients. Overall treatment outcomes were better in LPA-based algorithm compared ... |
format |
Article in Journal/Newspaper |
author |
Platon Eliseev Grigory Balantcev Elena Nikishova Anastasia Gaida Elena Bogdanova Donald Enarson Tara Ornstein Anne Detjen Russell Dacombe Elena Gospodarevskaya Patrick P J Phillips Gillian Mann Stephen Bertel Squire Andrei Mariandyshev |
author_facet |
Platon Eliseev Grigory Balantcev Elena Nikishova Anastasia Gaida Elena Bogdanova Donald Enarson Tara Ornstein Anne Detjen Russell Dacombe Elena Gospodarevskaya Patrick P J Phillips Gillian Mann Stephen Bertel Squire Andrei Mariandyshev |
author_sort |
Platon Eliseev |
title |
The Impact of a Line Probe Assay Based Diagnostic Algorithm on Time to Treatment Initiation and Treatment Outcomes for Multidrug Resistant TB Patients in Arkhangelsk Region, Russia. |
title_short |
The Impact of a Line Probe Assay Based Diagnostic Algorithm on Time to Treatment Initiation and Treatment Outcomes for Multidrug Resistant TB Patients in Arkhangelsk Region, Russia. |
title_full |
The Impact of a Line Probe Assay Based Diagnostic Algorithm on Time to Treatment Initiation and Treatment Outcomes for Multidrug Resistant TB Patients in Arkhangelsk Region, Russia. |
title_fullStr |
The Impact of a Line Probe Assay Based Diagnostic Algorithm on Time to Treatment Initiation and Treatment Outcomes for Multidrug Resistant TB Patients in Arkhangelsk Region, Russia. |
title_full_unstemmed |
The Impact of a Line Probe Assay Based Diagnostic Algorithm on Time to Treatment Initiation and Treatment Outcomes for Multidrug Resistant TB Patients in Arkhangelsk Region, Russia. |
title_sort |
impact of a line probe assay based diagnostic algorithm on time to treatment initiation and treatment outcomes for multidrug resistant tb patients in arkhangelsk region, russia. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2016 |
url |
https://doi.org/10.1371/journal.pone.0152761 https://doaj.org/article/72267107569445e4a08002411276157f |
genre |
Arkhangelsk |
genre_facet |
Arkhangelsk |
op_source |
PLoS ONE, Vol 11, Iss 4, p e0152761 (2016) |
op_relation |
https://doi.org/10.1371/journal.pone.0152761 https://doaj.org/toc/1932-6203 1932-6203 doi:10.1371/journal.pone.0152761 https://doaj.org/article/72267107569445e4a08002411276157f |
op_doi |
https://doi.org/10.1371/journal.pone.0152761 |
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PLOS ONE |
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11 |
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4 |
container_start_page |
e0152761 |
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