Presumptive DR-TB /risk groups

Clinical description

According to the national drug resistance survey13, previously treated patients are 12 times more likely to have DR-TB than new patients. Presumptive DR-TB patients are defined as the following risk groups:

• All patients, who remain smear-positive after 3 months of therapy with first-line

drugs14;

• Patients who have had contact with a known DR-TB patient;
• Failure of first line TB drugs
• Symptomatic contacts of a DR-TB patient who died while on directly observed TB

treatment;

• New patients coming from areas with high prevalence of DR TB;
• Health care workers in hospital/ health facility setting;
• Other previously treated TB Patients;
• TB patients returning after loss to follow-up;
• Any TB patients in whom there is significant clinical concern for acquired resistance.
• Whenever health workers encounter presumptive MDR-TB cases
• Submit sputum for microscopy or Xpert MTB/RIF, culture /DST.

Patients are assigned to a registration group based on the most recent treatment history at the time of collecting the biological specimen that waså used to confirm MDR-TB or RR-TB. All confirmed drug-resistant TB patients should be treated as per the national guidelines.

13 Abouyannis et al. 2014. Drug resistance of Mycobacterium tuberculosis in Malawi: a cross-sectional survey. Bull WHO; 92:798-806.

http://www.who.int/bulletin/volumes/92/11/13-126532/en/ Accessed 7 April 2017.

14 WHO. WHO treatment guidelines for drug-resistant tuberculosis.2016 Updates. Accessed on June 13,2017.

National Tuberculosis Control Programme 69