ArticleJournal of epidemiology and global health2017
Low pre-diagnosis attrition but high pre-treatment attrition among patients with MDR-TB: An operational research from Chennai, India.
Article in Journal of epidemiology and global health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Gender and other intersecting factors in antimicrobial resistance for infectious diseases of poverty: a systematic evidence gap analysis in low- and lower-middle-income countries.BMC public health · 2026Pooled it
- Barriers to engagement in the care cascade for tuberculosis disease in India: A systematic review of quantitative studies.PLoS medicine · 2024Pooled it
- Attrition and delays before treatment initiation among patients with MDR-TB in China (2006-13): Magnitude and risk factors.PloS one · 2019Trial
- Delayed diagnosis of patients with rifampicin-resistant tuberculosis and its associated factors in a high tuberculosis endemic area Guizhou, China.BMC infectious diseases · 2026Article
- Diagnosis and Treatment Pathway of MDR/RR-TB in Taizhou, Zhejiang Province, China.Tropical medicine and infectious disease · 2023Article
- Article
- Universal Access to Xpert MTB/RIF Testing for Diagnosis of Tuberculosis in Uzbekistan: How Well Are We Doing?International journal of environmental research and public health · 2021Article
- Overcoming the health system barriers to early diagnosis and management of multidrug-resistant tuberculosis in a rural setting in North India.BMJ case reports · 2020Article
- Where are patients missed in the tuberculosis diagnostic cascade? A prospective cohort study in Ghana.PloS one · 2020Article
- Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea.Public health action · 2019Article
- Predictors of Multidrug-Resistant Tuberculosis (MDR-TB) in Sudan.Antibiotics (Basel, Switzerland) · 2019Article
- Magnitude and reasons for pre-diagnosis attrition among presumptive multi-drug resistant tuberculosis patients in Bago Region, Myanmar: A mixed methods study.Scientific reports · 2019Article
- Delay and attrition before treatment initiation among MDR-TB patients in five districts of Gujarat, India.Public health action · 2018Article
- Operational Research in Health-care Settings.Indian journal of community medicine : official publication of Indian Association of Preventive & Social MedicineArticle
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Authors and funding
10 authors.
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Abstract
backgroundWorldwide, there's concern over high pre-diagnosis and pre-treatment attritions or delays in Multidrug resistant tuberculosis (MDR-TB) diagnosis and treatment pathway (DTP). We conducted this operational research among patients with presumptive MDR-TB in north and central Chennai, India to determine attrition and turnaround times (TAT) at various steps of DTP and factors associated with attrition.
methodsStudy was conducted in Revised National Tuberculosis Control Programme setting. It was a retrospective cohort study involving record review of all patients with presumptive MDR-TB (eligible for DST) in 2014.
resultsOf 628 eligible for DST, 557 (88%) underwent DST and 74 (13%) patients were diagnosed as having MDR-TB. Pre-diagnosis and pre-treatment attrition was 11% (71/628) and 38% (28/74) respectively. TAT [median (IQR)] to test from eligibility for DST and initiate DR-TB treatment from diagnosis were 14 (9,27) and 18 (13,36) days respectively. Patients with smear negative TB and detected in first quarter of 2014 were less likely to undergo DST. Patients in first quarter of 2014 had significantly lower risk of pre-treatment attrition.
conclusionThere was high uptake of DST. However, urgent attention is required to reduce pre-treatment attrition, improve TAT to test from eligibility for DST and improve DST among patients with smear-negative TB.
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