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Screening and treatment of tuberculosis

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P. D. O. Davies, D. M. Cullen. Liverpool Heart and Chest Hospital, Liverpool, UK

Introduction The low incidence of multidrug resistant tuberculosis (MDRTB) in the UK means that few specialists treating tuberculosis have much experience of managing patients with MDRTB and no mechanism for collecting data on the progress of such patients exists. To attempt to overcome this gap, with the support of relevant professional bodies and a grant from Genus Pharma, the MDRTB Service was established at the Liverpool Heart and Chest Hospital in January 2008.

Method The Service offers ready access to expert advice on the management of patients with MDRTB via an electronic committee of TB experts. The second function of the Service is to collect data on all MDRTB cases identified in the UK, to record outcomes and develop a consensus on the most effective methods of treatment.

Results This submission is an update to the report which was presented at the 2008 BTS winter meeting.1 Since its founding, the MDRTB Service has been approached with 62 TB cases. Of these, 48 were confirmed as MDR and 3 XDRTB while the remainder could not be confirmed as MDR, were isoniazid mono-resistant or were more general requests for advice. Regular updates on these cases are being sought and treatment patterns and results recorded. An analysis of the initial data shows that 69% of cases had received no previous treatment for TB. Over half were likely to have been infectious, with 57% of the cases being sputum smear positive at diagnosis. The majority of the cases were of a non-white ethnic background, the highest number being Asian (40%). The split between male and female was 65% male to 35% female, while 78% of cases were aged between 24 and 44. Drug resistance patterns revealed that MDRTB is …

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