- Bella Devaleenal Daniel, scientist1,
- Chandrasekaran Padmapriyadarsini, director1,
- Sidhartha Giri, scientist2,
- Paran Sarimita Winarni, vice chair and TB survivor3
- 1ICMR National Institute for Research in Tuberculosis, Chennai, India
- 2ICMR Regional Medical Research Centre, Bhubaneshwar, India
- 3Pejuang Tangguh (PETA), Jakarta, Indonesia
- Correspondence to: BD Daniel belladevalleenal.d{at}icmr.gov.in
What you need to know
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Universal drug susceptibility testing is key for early diagnosis of drug resistant tuberculosis (TB) and should be offered to all people with bacteriologically confirmed TB; rapid molecular diagnostic tests used as an initial di(eagnostic investigation can simultaneously detect Mycobacterium tuberculosis and drug susceptibility early.
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Treatment of people with multidrug resistant TB or rifampicin resistant TB with shorter oral regimens based on bedaquiline results in improved treatment success with better tolerability.
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Conduct monthly clinical and laboratory assessments (including sputum smear and culture) for people who are being treated for multidrug resistant TB or rifampicin resistant TB to monitor the treatment response and promptly detect and address adverse events.
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Refer people for evaluation and initiation of TB preventive treatment if they have been in contact with people with multidrug resistant TB.
A 45 year old man with diabetes mellitus self presents to the TB clinic with productive cough for the past month. The sputum was yellow in colour, copious, and was streaked with blood twice. In that time, he has also hadcontinuousfevers around 38°C, not associated with rigors, and he has lost around 5 kg of weight in the past two months. He reports undergoing treatment for drug sensitive TB three years ago, although he did not take his treatment regularly and did not complete the 6 month course. He lives with his wife and two children, none of whom have had any major respiratory illnesses or have been diagnosed with TB. He works in a garment factory for daily wages, does not drink alcohol, and is a former smoker, having smoked 10 cigarettes per day for 20 years, and quitting three years ago. A cartridge based nucleic acid amplification test of his sputum detected Mycobacterium tuberculosis with rifampicin resistance.A sputum smear for acid fast bacilli showed 3+, and …
