Management of previously treated tuberculosis patients in Kalutara district, Sri Lanka: how are we faring?

SETTING: District Chest Clinic, Kalutara, Sri Lanka.

OBJECTIVES: To determine the coverage of culture and drug susceptibility testing (CDST), delays in CDST, treatment initiation, obtaining CDST results and treatment outcomes of previously treated tuberculosis (TB) patients.

DESIGN: Retrospective cohort study involving review of records and reports. All previously treated TB patients from January 2008 to June 2013 were included in the study.

RESULTS: Of 160 patients, 126 (79%) samples were sent for CDST; 79 (63%) were culture-positive and no multi-drug-resistant (MDR) TB cases were reported. Respectively 9% and 15% of patients experienced a delay in sending samples (median delay 21 days) and receiving CDST reports (median delay 71 days), while 20% experienced delays in initiating the retreatment regimen (median delay 11.5 days). The cohort recorded an 82% treatment success rate.

CONCLUSION: Of all retreatment patients, only 79% were tested for CDST and there were sizeable delays in sample transportation and treatment initiation. Possible ways forward to strengthen the programme are discussed.