Impact of infection control measures to control an outbreak of multidrug-resistant tuberculosis in a human immunodeficiency virus ward, Peru

Eduardo Ticona, Luz Huaroto, Daniela E. Kirwan, Milagros Chumpitaz, César V. Munayco, Mónica Maguiña, Marco A. Tovar, Carlton A. Evans, Roderick Escombe, Robert H Gilman

Research output: Contribution to journalArticle

Abstract

Multidrug-resistant tuberculosis (MDRTB) rates in a human immunodeficiency virus (HIV) care facility increased by the year 2000-56% of TB cases, eight times the national MDRTB rate. We reported the effect of tuberculosis infection control measures that were introduced in 2001 and that consisted of 1) building a respiratory isolation ward with mechanical ventilation, 2) triage segregation of patients, 3) relocation of waiting room to outdoors, 4) rapid sputum smear microscopy, and 5) culture/drug-susceptibility testing with the microscopic-observation drug-susceptibility assay. Records pertaining to patients attending the study site between 1997 and 2004 were reviewed. Six hundred and fifty five HIV/TB-coinfected patients (mean age 33 years, 79% male) who attended the service during the study period were included. After the intervention, MDRTB rates declined to 20% of TB cases by the year 2004 (P = 0.01). Extremely limited access to antiretroviral therapy and specific MDRTB therapy did not change during this period, and concurrently, national MDRTB prevalence increased, implying that the infection control measures caused the fall in MDRTB rates. The infection control measures were estimated to have cost US91,031 while preventing 97 MDRTB cases, potentially saving US1,430,026. Thus, this intervention significantly reduced MDRTB within an HIV care facility in this resourceconstrained setting and should be cost-effective.

Original languageEnglish (US)
Pages (from-to)1247-1256
Number of pages10
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume95
Issue number6
DOIs
StatePublished - Dec 1 2016

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Multidrug-Resistant Tuberculosis
Peru
Infection Control
Disease Outbreaks
HIV
Costs and Cost Analysis
Triage
Sputum
Artificial Respiration
Pharmaceutical Preparations
Microscopy
Tuberculosis
Observation
Therapeutics

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

Impact of infection control measures to control an outbreak of multidrug-resistant tuberculosis in a human immunodeficiency virus ward, Peru. / Ticona, Eduardo; Huaroto, Luz; Kirwan, Daniela E.; Chumpitaz, Milagros; Munayco, César V.; Maguiña, Mónica; Tovar, Marco A.; Evans, Carlton A.; Escombe, Roderick; Gilman, Robert H.

In: American Journal of Tropical Medicine and Hygiene, Vol. 95, No. 6, 01.12.2016, p. 1247-1256.

Research output: Contribution to journalArticle

Ticona, Eduardo ; Huaroto, Luz ; Kirwan, Daniela E. ; Chumpitaz, Milagros ; Munayco, César V. ; Maguiña, Mónica ; Tovar, Marco A. ; Evans, Carlton A. ; Escombe, Roderick ; Gilman, Robert H. / Impact of infection control measures to control an outbreak of multidrug-resistant tuberculosis in a human immunodeficiency virus ward, Peru. In: American Journal of Tropical Medicine and Hygiene. 2016 ; Vol. 95, No. 6. pp. 1247-1256.
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