14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 33.004 Session: Tuberculosis: Epidemiology, Prevention & Control Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Transmission of drug resistant tuberculosis and its implication for TB control in rural China Y. Hu, W. Jiang, W. Wang, B. Xu School of Public Health, Fudan University, Shanghai, China Background: The transmission pattern of drug resistant TB might vary due to the difference in the geographic feature, socio-economic development and TB epidemic from specific areas and populations. This might also matter how effectively TB control program would work. The present study attempted to describe the transmission of drug resistant TB in two comparable rural Chinese areas albeit with different duration of direct observed treatment, short-course(DOTS) implementation, as well as to discuss about its possible implication for TB control policies. Methods: Setting in two rural counties: ten years’ DOTS covered Deqing and one year’s DOTS covered Guanyun, this study included the pulmonary drug resistant TB patients registered in local TB dispensaries as the subject. Proportion method and DNA sequencing determined drug resistant pattern and genetic mutation of M.TB isolates. IS6110-RFLP identified clustered patients and their epidemiological link was confirmed using concentric circle method. Results: Totally 223 of 351 isolates(63.5%) were resistant to at least one anti-TB drug, including 53(15.1%) simultaneously resistant to isoniazid and rifampicin or multidrug resistant(MDR-TB,18 from Deqing and 35 from Guanyun). Of the 168 patterns identified by IS6110-RFLP, 20 were shared only between drug resistant isolates; 12 were shared between the drug resistant isolates and the pan-drug sensitive isolates. Deqing and Guanyun had significantly different cluster proportion of drug resistant TB(32/101.vs.55/122,p=0.041) but similar cluster proportion of MDR- TB isolates(11/19.vs.22/34,p=0.624). The significant high cluster proportion was observed in the previous treated patients both in two counties but in the sputum smear positive patients with cavitaries alone in Guanyun, so does happen to those infected with the strain from Beijing genotype and resistant to isonazid and/or rifampicin. Of 87 clustered drug resistant strain, 67.8% was clustered in same or neighboring villageThe remained 71.4% were scatted along the traffic arteries. Conclusion: Transmission pattern of drug resistant TB was consistent with attenuated properties of pathogen as well as social activity of rural populations. Meanwhile, DOTS itself might not work enough on the recent transmission of MDR-TB. These observations might suggest the need of supplementing the additional strategies, including active case finding within village and effective treatment on patients previously treated or with cavitaries.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 33.005 Session: Tuberculosis: Epidemiology, Prevention & Control Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Evaluation of cost and methods for detecting latent tuberculosis infection among target individual groups in Trinidad & Tobago P. E. Akpaka 1 , S. Baboolal 2 , D. Ramoutar 3 1 The University of the West Indies, Faculty of Medical Sciences, Champ Fleurs, Trinidad and Tobago, 2 The University of the West Indies, Faculty of Medical Sciences, St. Augustine, Trinidad and Tobago, 3 North Regional Health Authority, Caura, Trinidad and Tobago Background: A huge amount of valuable time and resources is expended in the country using tuberculin skin test (TST) assay to screen for TB contacts and other subjects in the country. This study was carried out to compare using TST and QuantiFERON®-TB gold (QFT-G) assays in screening and diagnosis of latent tuberculosis infection (LTBI) in a cross section of high risk individuals for LTBI in Trinidad and Tobago. Methods: During a 9-months period, over 550 subjects including contacts of TB patients (n=200), HIV positive patients (n= 70), health care workers (45), prison inmates (65) and TB patients (180) used as controls were recruited for the study. Blood specimen was drawn from the subjects and processed in the laboratory using QuantiFERON®-TB Gold (QFT-G) kit and tuberculin solution was administered on the forearm. Data were analyzed with Epi Info 3.5.1 software (CDC, Atlanta, GA, USA). The chi-squared test and Fisher’s exact test were used as appropriate to compare data from the different groups. Data were descriptive and were reported as comparisons of frequency distributions. A P value
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