PLoS ONE (Jan 2014)

Impact of introducing the line probe assay on time to treatment initiation of MDR-TB in Delhi, India.

  • Neeta Singla,
  • Srinath Satyanarayana,
  • Kuldeep Singh Sachdeva,
  • Rafael Van den Bergh,
  • Tony Reid,
  • Katherine Tayler-Smith,
  • V P Myneedu,
  • Engy Ali,
  • Donald A Enarson,
  • Digamber Behera,
  • Rohit Sarin

DOI
https://doi.org/10.1371/journal.pone.0102989
Journal volume & issue
Vol. 9, no. 7
p. e102989

Abstract

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SETTING: National Institute of Tuberculosis and Respiratory Diseases (erstwhile Lala Ram Sarup Institute) in Delhi, India. OBJECTIVES: To evaluate before and after the introduction of the line Probe Assay (LPA) a) the overall time to MDR-TB diagnosis and treatment initiation; b) the step-by-step time lapse at each stage of patient management; and c) the lost to follow-up rates. METHODS: A retrospective cohort analysis was done using data on MDR-TB patients diagnosed during 2009-2012 under Revised National Tuberculosis Control Programme at the institute. RESULTS: Following the introduction of the LPA in 2011, the overall median time from identification of patients suspected for MDR-TB to the initiation of treatment was reduced from 157 days (IQR 127-200) to 38 days (IQR 30-79). This reduction was attributed mainly to a lower diagnosis time at the laboratory. Lost to follow-up rates were also significantly reduced after introduction of the LPA (12% versus 39% pre-PLA). CONCLUSION: Introduction of the LPA was associated with a major reduction in the delay between identification of patients suspected for MDR-TB and initiation of treatment, attributed mainly to a reduction in diagnostic time in the laboratory.