A. Smear- or culture-positive patients at risk for MDR-TB without prior treatment history |
Subjects may be referred for DST if they 1) are diagnosed with smear-positive pulmonary TB, 2) have no prior history of anti-tuberculosis treatment, and 3) have at least one of the following risk factors: |
1. Household contact of patient with documented MDR-TB or presumptive MDR-TB (i.e., in treatment with second-line drugs, failed anti-tuberculosis treatment or died of TB in past 2 years) |
2. HIV-positive by ELISA and Western Blot confirmation |
3. Diabetes mellitus |
4. Healthcare worker by profession, regardless of health care field, in the last 2 years |
5. Student of health sciences in the past 2 years |
6. Incarcerated or employee of the penitentiary system in the past 2 years |
7. Chronic treatment with corticosteroids |
8. Other condition of immunosuppression |
9. Adverse reaction to TB medications that has required a change in regimen |
10. Hospitalization for any indication in the past 2 years lasting more than 15 days |
11. Presumptive treatment failure of Category I or II regimen (i.e., smear- or culture-positive between 2 and 4 months of treatment) |
B. Patients who have received at least one previous course of treatment |
Subjects may be referred for DST if they have any of the prior TB treatment histories: |
1. Lost to follow-up for any previous regimen and now present for retreatment |
2. Relapsed after completion of any previous regimen within less than 6 months |
3. Treatment failed with any previous regimen |
4. Received multiple courses of anti-tuberculosis treatment |
5. Have a history of private or self-administered treatment |
C. Confirmed or presumptive smear-negative TB among high-risk groups (tested by BACTEC™) |
Subjects may be referred for DST if they 1) have presumptive or confirmed active pulmonary TB, 2) are smear-negative, and 3) have at least one of the following risk factors: |
1. Pediatric household contact of patient with documented MDR-TB |
2. Pediatric household contact of patient who has died of TB within the past 2 years |
3. HIV-positive by ELISA and Western Blot confirmation |