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Table 1 Peruvian National TB Control Program criteria for DST referral

From: Impact of HIV on mortality among patients treated for tuberculosis in Lima, Peru: a prospective cohort study

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

  1. DST drug susceptibility testing, ELISA enzyme-linked immunosorbent assay, HIV human immunodeficiency virus, MDR-TB multidrug-resistant tuberculosis, TB tuberculosis