Title:Gaps in the Diagnosis and Treatment of Drug-resistant Tuberculosis in
Mexico
Volume: 20
Issue: 1
Author(s): Rafael Laniado-Laborín*, Gerardo Castro-Mazon, Jorge Salcido-Gastélum, Nallely Saavedra-Herrera, Julio Magaña-Ocaña and Fátima Leticia Luna-López
Affiliation:
- Hospital General Tijuana, Clínica y Laboratorio de Tuberculosis. Tijuana Baja California, México
- Universidad
Autónoma de Baja California, Facultad de Medicina y Psicología, Tijuana, Baja California, México
Keywords:
Tuberculosis, drug-resistant, delays, diagnosis, treatment.
Abstract:
Objective: The study aimed to determine the critical gaps in the care of drug-resistant
tuberculosis to implement strategies for its elimination.
Material and Methods: Cases with various resistance profiles that were presented to the National
Advisory Group for Drug Resistance during the years 2019-2022 have been described.
Results and Discussion: 104 cases were included in this study. 41% of the patients had diabetes
(41%) as a comorbidity. There have been observed delays in the reporting of rapid molecular
tests; with the Xpert MTB/RIF, delays of 6.33 days have been reported. There have also been observed
delays in the request for phenotypic drug susceptibility tests; from the time of initial diagnosis,
patients have been found to receive their first drug susceptibility test, on average, after 20
months. The bacteriological follow-up during the treatment with monthly culture has been found
to only be carried out in 8% of the cases. In the contact investigation, only 16% of the listed contacts
had been studied for infection or active disease.
Conclusion: The elimination of these gaps requires the decentralization of susceptibility tests for
fluoroquinolones, shortening the times between the diagnosis of drug resistance and the start of
treatment, a close clinical and bacteriological follow-up, and an exhaustive investigation of contacts.