Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013
ABSTRACT Objective To assess whether the National Tuberculosis Program (NTP) guidelines for culture and drug sensitivity testing (DST) in Guatemala were successfully implemented, particularly in cases of smear-negative pulmonary tuberculosis (TB) or previously treated TB, by documenting notificatio...
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| Language: | English |
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Pan American Health Organization
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| Series: | Revista Panamericana de Salud Pública |
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| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892016000100044&lng=en&tlng=en |
| _version_ | 1818193755233058816 |
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| author | Maritza Samayoa-Peláez Nancy Ayala Zaida E. Yadon Einar Heldal |
| author_facet | Maritza Samayoa-Peláez Nancy Ayala Zaida E. Yadon Einar Heldal |
| author_sort | Maritza Samayoa-Peláez |
| collection | DOAJ |
| description | ABSTRACT Objective To assess whether the National Tuberculosis Program (NTP) guidelines for culture and drug sensitivity testing (DST) in Guatemala were successfully implemented, particularly in cases of smear-negative pulmonary tuberculosis (TB) or previously treated TB, by documenting notification rates by department (geographic area), disease type and category, and culture and DST results. Methods This was a cross-sectional, operational research study that merged and linked all patients registered by the NTP and the National Reference Laboratory in 2013, eliminating duplicates. The proportions with culture (for new smear negative pulmonary cases) and culture combined with DST (for previously treated patients) were estimated and analyzed by department. Data were analyzed using EpiData Analysis version 2.2. Results There were 3 074 patients registered with TB (all forms), for a case notification rate of 20/100 000 population. Of these, 2 842 had new TB, of which 2 167 (76%) were smear-positive pulmonary TB (PTB), 385 (14%) were smear-negative PTB, and 290 (10%) were extrapulmonary TB. There were 232 (8%) previously treated cases. Case notification rates (all forms) varied by department from 2–68 per 100 000 population, with the highest rates seen in the southwest and northeast part of Guatemala. Of new TB patients, 136 had a culture performed and 55 had DST of which the results were 33 fully sensitive, 9 monoresistant, 3 polyresistant, and 10 multidrug resistant TB (MDR-TB). Only 21 (5%) of new smear-negative PTB patients had cultures. Of 232 previously treated patients, 54 (23%) had a culture and 47 (20%) had DST, of which 29 were fully sensitive, 7 monoresistant, 2 polyresistant, and 9 MDR-TB. Of 22 departments (including the capital), culture and DST was performed in new smear-negative PTB in 7 departments (32%) and in previously treated TB in 13 departments (59%). Conclusions Despite national guidelines, only 5% of smear-negative PTB cases had a culture and only 20% of previously treated TB had a culture and DST. Several departments did not perform culture or DST. These short comings must be improved if Guatemala is to curtail the spread of drug resistant forms of TB, while striving to eliminate all TB. |
| first_indexed | 2024-12-12T00:51:26Z |
| format | Article |
| id | doaj.art-710e4a8687634168bf7b6e8880c34b1d |
| institution | Directory Open Access Journal |
| issn | 1680-5348 |
| language | English |
| last_indexed | 2024-12-12T00:51:26Z |
| publisher | Pan American Health Organization |
| record_format | Article |
| series | Revista Panamericana de Salud Pública |
| spelling | doaj.art-710e4a8687634168bf7b6e8880c34b1d2022-12-22T00:44:00ZengPan American Health OrganizationRevista Panamericana de Salud Pública1680-53483914450S1020-49892016000100044Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013Maritza Samayoa-PeláezNancy AyalaZaida E. YadonEinar HeldalABSTRACT Objective To assess whether the National Tuberculosis Program (NTP) guidelines for culture and drug sensitivity testing (DST) in Guatemala were successfully implemented, particularly in cases of smear-negative pulmonary tuberculosis (TB) or previously treated TB, by documenting notification rates by department (geographic area), disease type and category, and culture and DST results. Methods This was a cross-sectional, operational research study that merged and linked all patients registered by the NTP and the National Reference Laboratory in 2013, eliminating duplicates. The proportions with culture (for new smear negative pulmonary cases) and culture combined with DST (for previously treated patients) were estimated and analyzed by department. Data were analyzed using EpiData Analysis version 2.2. Results There were 3 074 patients registered with TB (all forms), for a case notification rate of 20/100 000 population. Of these, 2 842 had new TB, of which 2 167 (76%) were smear-positive pulmonary TB (PTB), 385 (14%) were smear-negative PTB, and 290 (10%) were extrapulmonary TB. There were 232 (8%) previously treated cases. Case notification rates (all forms) varied by department from 2–68 per 100 000 population, with the highest rates seen in the southwest and northeast part of Guatemala. Of new TB patients, 136 had a culture performed and 55 had DST of which the results were 33 fully sensitive, 9 monoresistant, 3 polyresistant, and 10 multidrug resistant TB (MDR-TB). Only 21 (5%) of new smear-negative PTB patients had cultures. Of 232 previously treated patients, 54 (23%) had a culture and 47 (20%) had DST, of which 29 were fully sensitive, 7 monoresistant, 2 polyresistant, and 9 MDR-TB. Of 22 departments (including the capital), culture and DST was performed in new smear-negative PTB in 7 departments (32%) and in previously treated TB in 13 departments (59%). Conclusions Despite national guidelines, only 5% of smear-negative PTB cases had a culture and only 20% of previously treated TB had a culture and DST. Several departments did not perform culture or DST. These short comings must be improved if Guatemala is to curtail the spread of drug resistant forms of TB, while striving to eliminate all TB.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892016000100044&lng=en&tlng=enTuberculosistécnicas de diagnóstico del sistema respiratoriotécnicas de diagnósticonormastuberculosis resistente a múltiples medicamentosinvestigación operativaGuatemalaAmérica Latina |
| spellingShingle | Maritza Samayoa-Peláez Nancy Ayala Zaida E. Yadon Einar Heldal Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013 Revista Panamericana de Salud Pública Tuberculosis técnicas de diagnóstico del sistema respiratorio técnicas de diagnóstico normas tuberculosis resistente a múltiples medicamentos investigación operativa Guatemala América Latina |
| title | Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013 |
| title_full | Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013 |
| title_fullStr | Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013 |
| title_full_unstemmed | Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013 |
| title_short | Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013 |
| title_sort | implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in guatemala 2013 |
| topic | Tuberculosis técnicas de diagnóstico del sistema respiratorio técnicas de diagnóstico normas tuberculosis resistente a múltiples medicamentos investigación operativa Guatemala América Latina |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892016000100044&lng=en&tlng=en |
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