In:
PLOS Global Public Health, Public Library of Science (PLoS), Vol. 2, No. 3 ( 2022-3-1), p. e0000180-
Abstract:
Tuberculosis (TB) is the leading cause of death among PLHIV and multidrug-resistant-TB (MDR-TB) is associated with high mortality. We examined the management for adult PLHIV coinfected with MDR-TB at ART clinics in lower income countries. Between 2019 and 2020, we conducted a cross-sectional survey at 29 ART clinics in high TB burden countries within the global IeDEA network. We used structured questionnaires to collect clinic-level data on the TB and HIV services and the availability of diagnostic tools and treatment for MDR-TB. Of 29 ART clinics, 25 (86%) were in urban areas and 19 (66%) were tertiary care clinics. Integrated HIV-TB services were reported at 25 (86%) ART clinics for pan-susceptible TB, and 14 (48%) clinics reported full MDR-TB services on-site, i.e. drug susceptibility testing [DST] and MDR-TB treatment. Some form of DST was available on-site at 22 (76%) clinics, while the remainder referred testing off-site. On-site DST for second-line drugs was available at 9 (31%) clinics. MDR-TB treatment was delivered on-site at 15 (52%) clinics, with 10 individualizing treatment based on DST results and five using standardized regimens alone. Bedaquiline was routinely available at 5 (17%) clinics and delamanid at 3 (10%) clinics. Although most ART clinics reported having integrated HIV and TB services, few had fully integrated MDR-TB services. There is a continued need for increased access to diagnostic and treatment options for MDR-TB patients and better integration of MDR-TB services into the HIV care continuum.
Type of Medium:
Online Resource
ISSN:
2767-3375
DOI:
10.1371/journal.pgph.0000180
DOI:
10.1371/journal.pgph.0000180.g001
DOI:
10.1371/journal.pgph.0000180.g002
DOI:
10.1371/journal.pgph.0000180.g003
DOI:
10.1371/journal.pgph.0000180.t001
DOI:
10.1371/journal.pgph.0000180.t002
DOI:
10.1371/journal.pgph.0000180.s001
DOI:
10.1371/journal.pgph.0000180.s002
DOI:
10.1371/journal.pgph.0000180.s003
DOI:
10.1371/journal.pgph.0000180.s004
DOI:
10.1371/journal.pgph.0000180.s005
DOI:
10.1371/journal.pgph.0000180.s006
DOI:
10.1371/journal.pgph.0000180.s007
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
3101394-6
