Do We Need to Detect Isoniazid Resistance in Addition to Rifampicin Resistance in Diagnostic Tests for Tuberculosis?
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{"title"=>"Do we need to detect isoniazid resistance in addition to rifampicin resistance in diagnostic tests for tuberculosis?", "type"=>"journal", "authors"=>[{"first_name"=>"Claudia M.", "last_name"=>"Denkinger", "scopus_author_id"=>"23977479300"}, {"first_name"=>"Madhukar", "last_name"=>"Pai", "scopus_author_id"=>"14054425400"}, {"first_name"=>"David W.", "last_name"=>"Dowdy", "scopus_author_id"=>"6603069678"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84896779657", "sgr"=>"84896779657", "pui"=>"372577184", "isbn"=>"1932-6203 (Electronic)\\n1932-6203 (Linking)", "pmid"=>"24404155", "doi"=>"10.1371/journal.pone.0084197"}, "id"=>"890b587d-40fb-39e7-8d91-d70a510282e1", "abstract"=>"BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is resistant to both rifampicin (RIF) and isoniazid (INH). Whereas many TB diagnostics detect RIF-resistance, few detect INH-monoresistance, which is common and may increase risk of acquired MDR-TB. Whether inclusion of INH-resistance in a first-line rapid test for TB would have an important impact on MDR-TB rates remains uncertain.\\n\\nMETHODS: WE DEVELOPED A TRANSMISSION MODEL TO EVALUATE THREE TESTS IN A POPULATION SIMILAR TO THAT OF INDIA: a rapid molecular test for TB, the same test plus RIF-resistance detection (\"TB+RIF\"), and detection of RIF and INH-resistance (\"TB+RIF/INH\"). Our primary outcome was the prevalence of INH-resistant and MDR-TB at ten years.\\n\\nRESULTS: Compared to the TB test alone and assuming treatment of all diagnosed MDR cases, the TB+RIF test reduced the prevalence of MDR-TB among all TB cases from 5.5{%} to 3.8{%} (30.6{%} reduction, 95{%} uncertainty range, UR: 17-54{%}). Despite using liberal assumptions about the impact of INH-monoresistance on treatment outcomes and MDR-TB acquisition, expansion from TB+RIF to TB+RIF/INH lowered this prevalence only from 3.8{%} to 3.6{%} further (4{%} reduction, 95{%} UR: 3-7{%}) and INH-monoresistant TB from 15.8{%} to 15.1{%} (4{%} reduction, 95{%} UR: (-8)-19{%}).\\n\\nCONCLUSION: When added to a rapid test for TB plus RIF-resistance, detection of INH-resistance has minimal impact on transmission of TB, MDR-TB, and INH-monoresistant TB.", "link"=>"http://www.mendeley.com/research/we-need-detect-isoniazid-resistance-addition-rifampicin-resistance-diagnostic-tests-tuberculosis", "reader_count"=>78, "reader_count_by_academic_status"=>{"Unspecified"=>5, "Researcher"=>18, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>11, "Student > Postgraduate"=>4, "Student > Master"=>14, "Other"=>9, "Student > Bachelor"=>6, "Lecturer"=>1, "Professor"=>5, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>5, "Researcher"=>18, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>11, "Student > Postgraduate"=>4, "Student > Master"=>14, "Other"=>9, "Student > Bachelor"=>6, "Lecturer"=>1, "Professor"=>5, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>9, "Environmental Science"=>1, "Nursing and Health Professions"=>6, "Biochemistry, Genetics and Molecular Biology"=>2, "Agricultural and Biological Sciences"=>15, "Medicine and Dentistry"=>37, "Pharmacology, Toxicology and Pharmaceutical Science"=>2, "Social Sciences"=>3, "Computer Science"=>1, "Immunology and Microbiology"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>37}, "Social Sciences"=>{"Social Sciences"=>3}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>15}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>6}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Unspecified"=>{"Unspecified"=>9}, "Environmental Science"=>{"Environmental Science"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>2}}, "reader_count_by_country"=>{"Colombia"=>1, "United States"=>1, "Mexico"=>1, "Spain"=>1, "India"=>1}, "group_count"=>2}

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  • {"files"=>["https://ndownloader.figshare.com/files/1338333"], "description"=>"<p>Dashed boxes contain subjects that are infectious. All latent active, failure and treated/cured boxes are subdivided by drug sensitivity (sensitive; multi-drug resistant, MDR; isoniazid monoresistant, INHr). As illustrated in the inset, MDR may arise directly from susceptible strains or (with increased probability) from INHr-TB.</p>", "links"=>[], "tags"=>["Computational biology", "Population modeling", "Infectious disease modeling", "Infectious diseases", "Bacterial diseases", "tuberculosis", "Multi-drug-resistant tuberculosis", "Tropical diseases (non-neglected)", "Infectious disease control"], "article_id"=>893805, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Claudia M. Denkinger", "Madhukar Pai", "David W. Dowdy"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0084197.g001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Study_flow_diagram_/893805", "title"=>"Study flow diagram.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-03 02:55:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1338335"], "description"=>"<p>Trajectory of overall TB incidence (solid lines, left axis) and mortality (dotted lines, right axis) over 10 years with introduction of a molecular test for diagnosis and detection of rifampin (RIF) resistance, with or without a molecular test for isoniazid (INH) resistance. Grey lines correspond to the high-coverage scenario (i.e. 50%, 80% and 100% coverage among new, previously treated and failure cases, respectively, excluding those with no access to care), green lines to an alternative lower-coverage scenario (15%, 25%, and 30% among new, previously treated and failure). The curves for TB+RIF versus TB+RIF/INH are indistinguishable on the graph because the projected outcomes are so similar (see inset with incidence from year 8–10 for high coverage scenarios).</p>", "links"=>[], "tags"=>["Computational biology", "Population modeling", "Infectious disease modeling", "Infectious diseases", "Bacterial diseases", "tuberculosis", "Multi-drug-resistant tuberculosis", "Tropical diseases (non-neglected)", "Infectious disease control", "incidence"], "article_id"=>893807, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Claudia M. Denkinger", "Madhukar Pai", "David W. Dowdy"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0084197.g002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Impact_of_resistance_testing_on_incidence_and_mortality_/893807", "title"=>"Impact of resistance testing on incidence and mortality.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-03 02:55:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1338336"], "description"=>"<p>Projected trajectories for multi-drug resistant (MDR) (A, C) and INH-resistance (INHr) (B, D) cases with TB detection, TB+RIF and TB+RIF/INH over ten years. Results are shown as the absolute number of MDR or INHr cases per 100,000 (A, B) and as a proportion of all cases (new cases and relapse/default cases) detected (C, D).</p>", "links"=>[], "tags"=>["Computational biology", "Population modeling", "Infectious disease modeling", "Infectious diseases", "Bacterial diseases", "tuberculosis", "Multi-drug-resistant tuberculosis", "Tropical diseases (non-neglected)", "Infectious disease control", "multi-drug", "isoniazid"], "article_id"=>893808, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Claudia M. Denkinger", "Madhukar Pai", "David W. Dowdy"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0084197.g003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Impact_of_resistance_testing_on_multi_drug_and_isoniazid_resistance_/893808", "title"=>"Impact of resistance testing on multi-drug and isoniazid resistance.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-03 02:55:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1338337"], "description"=>"<p>Absolute percent change of MDR among all cases by year 10 if scenarios with TB+RIF and TB+RIF/INH are compared and one variable (in y-axis) is changed over the range defined in Table S4 in File S1.</p>", "links"=>[], "tags"=>["Computational biology", "Population modeling", "Infectious disease modeling", "Infectious diseases", "Bacterial diseases", "tuberculosis", "Multi-drug-resistant tuberculosis", "Tropical diseases (non-neglected)", "Infectious disease control"], "article_id"=>893809, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Claudia M. Denkinger", "Madhukar Pai", "David W. Dowdy"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0084197.g004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Sensitivity_analysis_/893809", "title"=>"Sensitivity analysis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-03 02:55:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1338338"], "description"=>"<p>Incidence, mortality and proportion of resistant among detected new, relapse/default and total cases by year ten with different interventions in high- and low-coverage scenarios.</p>", "links"=>[], "tags"=>["Computational biology", "Population modeling", "Infectious disease modeling", "Infectious diseases", "Bacterial diseases", "tuberculosis", "Multi-drug-resistant tuberculosis", "Tropical diseases (non-neglected)", "Infectious disease control"], "article_id"=>893810, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Claudia M. Denkinger", "Madhukar Pai", "David W. Dowdy"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0084197.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Projected_tuberculosis_outcomes_/893810", "title"=>"Projected tuberculosis outcomes.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-03 02:55:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1338339"], "description"=>"<p>upper margin defined by value necessary to attain doubling of proportion MDR over the duration of model period</p><p>Further information on treatment outcomes is available in Table S2 (in File S1) in the supplement; outcomes are expressed as probabilities per treatment episode.</p><p>Abbreviations: TB =  tuberculosis, INHr =  Isoniazid monoresistant, MDR =  multi-drug resistant (i.e., resistant to isoniazid and rifampin, DST =  drug-susceptibility testing, DS-TB =  drug-susceptible TB</p>", "links"=>[], "tags"=>["Computational biology", "Population modeling", "Infectious disease modeling", "Infectious diseases", "Bacterial diseases", "tuberculosis", "Multi-drug-resistant tuberculosis", "Tropical diseases (non-neglected)", "Infectious disease control"], "article_id"=>893811, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Claudia M. Denkinger", "Madhukar Pai", "David W. Dowdy"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0084197.t001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Definition_and_values_of_key_model_parameters_/893811", "title"=>"Definition and values of key model parameters.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-03 02:55:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1338342", "https://ndownloader.figshare.com/files/1338343", "https://ndownloader.figshare.com/files/1338344", "https://ndownloader.figshare.com/files/1338345", "https://ndownloader.figshare.com/files/1338346", "https://ndownloader.figshare.com/files/1338347", "https://ndownloader.figshare.com/files/1338348"], "description"=>"<div><p>Background</p><p>Multidrug-resistant tuberculosis (MDR-TB) is resistant to both rifampicin (RIF) and isoniazid (INH). Whereas many TB diagnostics detect RIF-resistance, few detect INH-monoresistance, which is common and may increase risk of acquired MDR-TB. Whether inclusion of INH-resistance in a first-line rapid test for TB would have an important impact on MDR-TB rates remains uncertain.</p><p>Methods</p><p>We developed a transmission model to evaluate three tests in a population similar to that of India: a rapid molecular test for TB, the same test plus RIF-resistance detection (“TB+RIF”), and detection of RIF and INH-resistance (“TB+RIF/INH”). Our primary outcome was the prevalence of INH-resistant and MDR-TB at ten years.</p><p>Results</p><p>Compared to the TB test alone and assuming treatment of all diagnosed MDR cases, the TB+RIF test reduced the prevalence of MDR-TB among all TB cases from 5.5% to 3.8% (30.6% reduction, 95% uncertainty range, UR: 17–54%). Despite using liberal assumptions about the impact of INH-monoresistance on treatment outcomes and MDR-TB acquisition, expansion from TB+RIF to TB+RIF/INH lowered this prevalence only from 3.8% to 3.6% further (4% reduction, 95% UR: 3–7%) and INH-monoresistant TB from 15.8% to 15.1% (4% reduction, 95% UR: (-8)-19%).</p><p>Conclusion</p><p>When added to a rapid test for TB plus RIF-resistance, detection of INH-resistance has minimal impact on transmission of TB, MDR-TB, and INH-monoresistant TB.</p></div>", "links"=>[], "tags"=>["Computational biology", "Population modeling", "Infectious disease modeling", "Infectious diseases", "Bacterial diseases", "tuberculosis", "Multi-drug-resistant tuberculosis", "Tropical diseases (non-neglected)", "Infectious disease control", "isoniazid", "rifampicin", "diagnostic"], "article_id"=>893814, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Claudia M. Denkinger", "Madhukar Pai", "David W. Dowdy"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0084197.s001", "https://dx.doi.org/10.1371/journal.pone.0084197.s002", "https://dx.doi.org/10.1371/journal.pone.0084197.s003", "https://dx.doi.org/10.1371/journal.pone.0084197.s004", "https://dx.doi.org/10.1371/journal.pone.0084197.s005", "https://dx.doi.org/10.1371/journal.pone.0084197.s006", "https://dx.doi.org/10.1371/journal.pone.0084197.s007"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Do_We_Need_to_Detect_Isoniazid_Resistance_in_Addition_to_Rifampicin_Resistance_in_Diagnostic_Tests_for_Tuberculosis_/893814", "title"=>"Do We Need to Detect Isoniazid Resistance in Addition to Rifampicin Resistance in Diagnostic Tests for Tuberculosis?", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2014-01-03 02:55:22"}

PMC Usage Stats | Further Information

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Relative Metric

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