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Year : 2013  |  Volume : 31  |  Issue : 2  |  Page : 130-137

A rapid and low-cost microscopic observation drug susceptibility assay for detecting TB and MDR-TB among individuals infected by HIV in South India

1 Infectious Diseases Laboratory, YRG Centre for AIDS Research and Education (YRG CARE), Chennai, India
2 Medical Centre, YRG Centre for AIDS Research and Education (YRG CARE); Department of Chest Diseases, International Training and Education Center for Health India (I-TECH), Chennai, India
3 Medical Centre, YRG Centre for AIDS Research and Education (YRG CARE), Chennai, India
4 Department of Chest Diseases, Balaji Medical College and Hospital, Chennai, India
5 Department of Chest Diseases, Government Hospital of Thoracic Medicine, Chennai, India
6 Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA and TB Centre and Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK

Correspondence Address:
S Solomon
Infectious Diseases Laboratory, YRG Centre for AIDS Research and Education (YRG CARE), Chennai, India

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Source of Support: The World Bank Development Marketplace Grant, Conflict of Interest: None

DOI: 10.4103/0255-0857.115225

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Background: The converging epidemics of HIV and tuberculosis (TB) pose one of the greatest public health challenges of our time. Rapid diagnosis of TB is essential in view of its infectious nature, high burden of cases, and emergence of drug resistance. Objective: The purpose of this present study was to evaluate the feasibility of implementing the microscopic observation drug susceptibility (MODS) assay, a novel assay for the diagnosis of TB and multi-drug-resistant tuberculosis (MDR-TB) directly from sputum specimens, in the Indian setting. Materials and Methods: This study involved a cross-sectional, blinded assessment of the MODS assay on 1036 suspected cases of pulmonary TB in HIV-positive and HIV-negative patients against the radiometric method, BD-BACTEC TB 460 system. Results: Overall, the sensitivity, specificity, positive predictive value, and negative predictive value of the MODS assay in detecting MTB among TB suspected patients were 89.1%, 99.1%, 94.2%, 95.8%, respectively. In addition, in the diagnosis of drug-resistant TB, the MODS assay was 84.2% sensitive for those specimens reporting MDR, 87% sensitivity for those specimens reporting INH mono-resistance, and 100% sensitive for specimens reporting RIF mono-resistance. The median time to detection of TB in the MODS assay versus BACTEC was 9 versus 21 days (P < 0.001). Conclusion: Costing 5 to 10 times lesser than the automated culture methods, the MODS assay has the potential clinical utility as a simple and rapid method. It could be effectively used as an alternative method for diagnosing TB and detection of MDR-TB in a timely and affordable way in resource-limited settings.


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