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A Prospective Study of Tuberculosis Drug Susceptibility in Sabah, Malaysia, and an Algorithm for Management of Isoniazid Resistance

Rashid Ali, Muhammad Redzwan S., Parameswaran, Uma, William, Timothy, Bird, Elspeth, Wilkes, Christopher S., Lee, Wai Khew, Yeo, Tsin Wen, Anstey, Nicholas M., Ralph, Anna P. and Yeo, Tsin (2015). A Prospective Study of Tuberculosis Drug Susceptibility in Sabah, Malaysia, and an Algorithm for Management of Isoniazid Resistance. Journal of Tropical Medicine,2015(Art no 261925):1-8.

Document type: Journal Article
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IRMA ID 75039815xPUB843
NHMRC Grant No. 605806
1016567
Title A Prospective Study of Tuberculosis Drug Susceptibility in Sabah, Malaysia, and an Algorithm for Management of Isoniazid Resistance
Author Rashid Ali, Muhammad Redzwan S.
Parameswaran, Uma
William, Timothy
Bird, Elspeth
Wilkes, Christopher S.
Lee, Wai Khew
Yeo, Tsin Wen
Anstey, Nicholas M.
Ralph, Anna P.
Yeo, Tsin
Journal Name Journal of Tropical Medicine
Publication Date 2015
Volume Number 2015
Issue Number Art no 261925
ISSN 1687-9686   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84925582856
Start Page 1
End Page 8
Total Pages 8
HERDC Category C1 - Journal Article (DIISR)
Abstract Introduction. The burden of tuberculosis is high in eastern Malaysia, and rates of Mycobacterium tuberculosis drug resistance are poorly defined. Our objectives were to determine M. tuberculosis susceptibility and document management after receipt of susceptibility results. Methods. Prospective study of adult outpatients with smear-positive pulmonary tuberculosis (PTB) in Sabah, Malaysia. Additionally, hospital clinicians accessed the reference laboratory for clinical purposes during the study. Results. 176 outpatients were enrolled; 173 provided sputum samples. Mycobacterial culture yielded M. tuberculosis in 159 (91.9%) and nontuberculous Mycobacterium (NTM) in three (1.7%). Among outpatients there were no instances of multidrug resistant M. tuberculosis (MDR-TB). Seven people (4.5%) had isoniazid resistance (INH-R); all were switched to an appropriate second-line regimen for varying durations (4.5–9 months). Median delay to commencement of the second-line regimen was 13 weeks. Among 15 inpatients with suspected TB, 2 had multidrug resistant TB (one extensively drug resistant), 2 had INH-R, and 4 had NTM. Conclusions. Current community rates of MDR-TB in Sabah are low. However, INH-resistance poses challenges, and NTM is an important differential diagnosis in this setting, where smear microscopy is the usual diagnostic modality. To address INH-R management issues in our setting, we propose an algorithm for the treatment of isoniazid-resistant PTB.
DOI http://dx.doi.org/10.1155/2015/261925   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 3.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 3.0 License
URL https://creativecommons.org/licenses/by/3.0/au


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