ArticlePloS one2011
High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.
Article in PloS one, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Differential yield of universal versus selective drug susceptibility testing of patients with tuberculosis in high-burden countries: a systematic review and meta-analysis.BMJ global health · 2020Pooled it
- Evaluation of T-NGS, Xpert Ultra, and Line Probe Assay on Clinical Samples for the Diagnosis of Drug-Resistant Pulmonary Tuberculosis in Rio de Janeiro.Revista da Sociedade Brasileira de Medicina Tropical · 2025Article
- Population-wide active case finding as a strategy to end TB.The Lancet regional health. Western Pacific · 2024Review
- Prison as a driver of recent transmissions of multidrug-resistant tuberculosis in Callao, Peru: a cross-sectional study.Lancet regional health. Americas · 2024Article
- Assessment of risk factors associated with multi-drug resistant tuberculosis (MDR-TB) in Gulu regional referral hospital.African health sciences · 2023Article
- Social Contact Patterns Associated With Tuberculosis: A Case-control Study in Southwest Iran.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2022Article
- Proportion and trend of primary resistance among Multidrug resistant Tuberculosis patients in Ethiopia.Journal of clinical tuberculosis and other mycobacterial diseases · 2022Article
- Trends in primary multidrug-resistant tuberculosis in the State of Rio de Janeiro: a retrospective study conducted during 2000-2019.Revista da Sociedade Brasileira de Medicina Tropical · 2021Article
- The fourth national anti-tuberculosis drug resistance survey in Peru.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2020Article
- A Case-Control Study to Identify Community Venues Associated with Genetically-clustered, Multidrug-resistant Tuberculosis Disease in Lima, Peru.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Persistently high prevalence of primary resistance and multidrug resistance of tuberculosis in Heilongjiang Province, China.BMC infectious diseases · 2016Article
- Determinants of multidrug-resistant tuberculosis in Henan province in China: a case control study.BMC public health · 2016Article
- Prevalence, Risk Factors, and Treatment Outcomes of Isoniazid- and Rifampicin-Mono-Resistant Pulmonary Tuberculosis in Lima, Peru.PloS one · 2016Article
- Comparing risk factors for primary multidrug-resistant tuberculosis and primary drug-susceptible tuberculosis in Jiangsu province, China: a matched-pairs case-control study.The American journal of tropical medicine and hygiene · 2015Article
- Patient Characteristics Associated with Tuberculosis Treatment Default: A Cohort Study in a High-Incidence Area of Lima, Peru.PloS one · 2015Article
- Factors associated with primary transmission of multidrug-resistant tuberculosis compared with healthy controls in Henan Province, China.Infectious diseases of poverty · 2015Article
- Management of patients with multidrug-resistant/extensively drug-resistant tuberculosis in Europe: a TBNET consensus statement.The European respiratory journal · 2014Article
- Genetic variability of Mycobacterium tuberculosis complex in patients with no known risk factors for MDR-TB in the North-Eastern part of Lima, Peru.BMC infectious diseases · 2013Article
- Association of major depressive episode with negative outcomes of tuberculosis treatment.PloS one · 2013Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn high multidrug resistant (MDR) tuberculosis (TB) prevalence areas, drug susceptibility testing (DST) at diagnosis is recommended for patients with risk factors for MDR. However, this approach might miss a substantial proportion of MDR-TB in the general population. We studied primary MDR in patients considered to be at low risk of MDR-TB in Lima, Peru.
methodsWe enrolled new sputum smear-positive TB patients who did not report any MDR-TB risk factor: known exposure to a TB patient whose treatment failed or who died or who was known to have MDR-TB; immunosuppressive co-morbidities, ex prison inmates; prison and health care workers; and alcohol or drug abuse. A structured questionnaire was applied to all enrolled participants to confirm the absence of these factors and thus minimize underreporting. Sputum from all participants was cultured on Löwenstein-Jensen media and DST for first line drugs was performed using the 7H10 agar method.
resultsOf 875 participants with complete data, 23.2% (203) had risk factors for MDR-TB elicited after enrolment. Among the group with no reported risk factors who had a positive culture, we found a 6.3% (95%CI 4.4-8.3) (37/584) rate of MDR-TB. In this group no epidemiological characteristics were associated with MDR-TB. Thus, in this group, multidrug resistance occurred in patients with no identifiable risk factors.
conclusionsWe found a high rate of primary MDR-TB in a general population with no identifiable risk factors for MDR-TB. This suggests that in a high endemic area targeting patients for MDR-TB based on the presence of risk factors is an insufficient intervention.
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