AI Article Synopsis
- The FAST strategy significantly improved the diagnosis and treatment of pulmonary tuberculosis in a hospital in Peru by increasing the rate of drug susceptibility testing and treatment initiation.
- More patients treated under the FAST approach were diagnosed with drug-resistant tuberculosis compared to historical controls, indicating a better detection system.
- The implementation of FAST reduced the time from hospital admission to the start of TB treatment, suggesting it is an effective method for managing tuberculosis in high-prevalence areas.
Article Abstract
Objective: To evaluate the effect of the FAST (Find cases Actively, Separate safely, Treat effectively) strategy on time to tuberculosis diagnosis and treatment for patients at a general hospital in a tuberculosis-endemic setting.
Design: Prospective cohort study with historical controls.
Participants: Patients diagnosed with pulmonary tuberculosis during hospitalization at Hospital Nacional Hipolito Unanue in Lima, Peru.
Methods: The FAST strategy was implemented from July 24, 2016, to December 31, 2019. We compared the proportion of patients with drug susceptibility testing and tuberculosis treatment during FAST to the 6-month period prior to FAST. Times to diagnosis and tuberculosis treatment were also compared using Kaplan-Meier plots and Cox regressions.
Results: We analyzed 75 patients diagnosed with pulmonary tuberculosis through FAST. The historical cohort comprised 76 patients. More FAST patients underwent drug susceptibility testing (98.7% vs 57.8%; OR, 53.8; < .001), which led to the diagnosis of drug-resistant tuberculosis in 18 (24.3%) of 74 of the prospective cohort and 4 (9%) of 44 of the historical cohort (OR, 3.2; = .03). Overall, 55 FAST patients (73.3%) started tuberculosis treatment during hospitalization compared to 39 (51.3%) controls (OR, 2.44; = .012). FAST reduced the time from hospital admission to the start of TB treatment (HR, 2.11; 95% CI, 1.39-3.21; < .001).
Conclusions: Using the FAST strategy improved the diagnosis of drug-resistant tuberculosis and the likelihood and speed of starting treatment among patients with pulmonary tuberculosis at a general hospital in a tuberculosis-endemic setting. In these settings, the FAST strategy should be considered to reduce tuberculosis transmission while simultaneously improving the quality of care.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8983787 | PMC |
| http://dx.doi.org/10.1017/ice.2021.422 | DOI Listing |
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