Impact of Introducing the Line Probe Assay on Time to Treatment Initiation of MDR-TB in Delhi, India

Citation: Singla N, Satyanarayana S, Sachdeva KS, Van den Bergh R, Reid T, et al. (2014) Impact of Introducing the Line Probe Assay on Time to Treatment Initiation of MDR-TB in Delhi, India. PLoS ONE 9(7): e102989. doi:10.1371/journal.pone.0102989
Published: July 24, 2014

Abstract
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.

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