Digital Commons Network^™

Gene Expression Profiling Of Mapk Pathway Inhibitor Resistance In Cutaneous Melanoma: Can Bioinformatics Be Used To Select Better Melanoma Cell Lines?, Stephen Luebker

Theses & Dissertations

Melanoma is the deadliest form of skin cancer, and incidence has continued to increase. Half of all melanomas have a BRAF V600E mutation and respond to MAPK pathway inhibitors, including BRAF inhibitor therapy or BRAF/MEK inhibitor combination therapy, but nearly all patients develop treatment resistance. Melanoma cell lines produce variable results as models of MAPK pathway inhibitor resistance. To better understand how the genomic similarity of a melanoma cell line to patient-derived tumors affects resistance mechanisms, differences in DNA mutations and copy-number alterations were compared between melanoma cell lines profiled by the Cancer Cell Line Encyclopedia and cutaneous melanoma tumors …

The Staphylococcus Aureus Lrgab Operon Encodes A Holin-Like Protein Involved In Pyruvate Transport, Jennifer L. Endres

Theses & Dissertations

The Staphylococcus aureus cidABC and lrgAB operons encode a well-conserved family of proteins involved in programmed cell death (PCD) during biofilm development. Based on the structural similarities that CidA and LrgA share with bacteriophage holins, we have hypothesized that these proteins function by forming pores within the cytoplasmic membrane. To test this, we utilized a “lysis cassette” system that demonstrated the abilities of the cidA and lrgA genes to support bacteriophage endolysin-induced cell lysis. In addition, the CidA and LrgA proteins were shown to localize to the surface of membrane vesicles and cause leakage of small molecules, providing direct evidence …

Dissolvable Microneedles And Nanofiber Dressings To Eradicate Biofilms And Improve Wound Care, Jenna Cusick, Jingwei Xie, Yajuan Su

Posters: 2021 Summer Undergraduate Research Program

Biofilms are communities of microorganisms consisting of one or more bacterial species that attach to a biotic or abiotic surface. Biofilms are highly common in chronic wounds. To improve wound care treatment, a Janus-type antimicrobial dressing was created to eradicate biofilms in chronic wounds. The dressing consists of two layers: a top layer of electrospun nanofibers and a bottom layer of dissolvable microneedles. The dressings were tested on an ex vivo and in vivo model.

Comparison Of Nucleic Acid Extraction Kits For Detecting Pathogens In Spiked Human Serum, Kate Berzonsky, Catherine Pratt, Bailey White, Dylan George, Mike Wiley Phd

Posters: 2021 Summer Undergraduate Research Program

Nucleic acid extraction is a laboratory process by which DNA and RNA can be isolated for downstream applications. Currently, there are many commercial DNA and RNA extraction kits available to simplify this process. These kits vary in cost, processing time, and required materials. While most studies comparing commercial extraction kits analyze using real-time qPCR, DNA sequencing has become a popular technique for determining specific pathogens present in microbial communities. This study compares the ability of 11 different nucleic extraction kits to detect pathogens from samples spiked with known proportions of bacteria and yeast. Additionally, variations of the kits were performed, …

Neutrophils In Pancreatic Cancer Progression, Paran Goel

Theses & Dissertations

Pancreatic cancer (PC) remains a challenge to modern-day cancer therapeutics, with a dismal five-year survival rate of 10%. Due to the pancreas's location and desmoplasia surrounding it, patients receive late diagnoses and fail to respond to chemotherapy regimens. Tumor-promoting inflammation, one of the emerging hallmarks of cancer, contributes to tumor cells' survival and proliferation. This inflammation is often the result of infiltrating leukocytes and pro-inflammatory cytokines released into the tumor microenvironment (TME).

Neutrophils, one of the most prominent immune cells in our body, play an essential role in sustaining this smoldering inflammation observed in the TME. Previously, our group has …

The Impact Of Obesity On Covid-19 Outcomes In A High-Risk, Majority Hispanic Community Sample, Maxwell A. Lawlor

Capstone Experience: Master of Public Health

The novel coronavirus disease 2019 (COVID-19) pandemic has caused over 33.7 million cases and 605,000 deaths in the United States¹. Factors associated with increased odds for hospitalization, death, and other poor outcomes include age, comorbid conditions like cardiovascular disease and lung disease, and obesity. COVID-19 has also disproportionately affected Hispanic communities across the United States and in Omaha. Potential explanations for this disparity include social determinants of health, particularly occupational factors, structural challenges to access healthcare services, and increased medical comorbidities including obesity. In this retrospective cohort study, we used patient data from April to May 2020 (N=1,000) …

Gray Matter Volumes Discriminate Cognitively Impaired And Unimpaired People With Hiv, Mikki Schantell, Brittany K. Taylor, Brandon Lew, Jennifer O'Neill, Pamela E. May, Susan Swindells, Tony W. Wilson

Journal Articles: Infectious Diseases

BACKGROUND: Current diagnostic criteria of HIV-associated neurocognitive disorders (HAND) rely on neuropsychological assessments. The aim of this study was to evaluate if gray matter volumes (GMV) can distinguish people with HAND, neurocognitively unimpaired people with HIV (unimpaired PWH), and uninfected controls using linear discriminant analyses.

METHODS: A total of 231 participants, including 110 PWH and 121 uninfected controls, completed a neuropsychological assessment and an MRI protocol. Among PWH, HAND (n = 48) and unimpaired PWH (n = 62) designations were determined using the widely accepted Frascati criteria. We then assessed the extent to which GMV, corrected for intracranial volume, could …

Capacity Building For A New Multicenter Network Within The Echo Idea States Pediatric Clinical Trials Network, Robert D. Annett, Scott Bickel, John C. Carlson, Kelly Cowan, Sara Cox, Mark J. Fisher, J. Dean Jarvis, Alberta S. Kong, Jessica S. Kosut, Kurtis R. Kulbeth, Abbot Laptook, Pearl A. Mcelfish, Mary M. Mcnally, Lee M. Pachter, Barbara A. Pahud, Lee A. Pyles, Jennifer Shaw, Kari Simonsen, Jessica Snowden, Christine B. Turley, Andrew M. Atz

Journal Articles: Pediatrics

Introduction: Research capacity building is a critical component of professional development for pediatrician scientists, yet this process has been elusive in the literature. The ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) seeks to implement pediatric trials across medically underserved and rural populations. A key component of achieving this objective is building pediatric research capacity, including enhancement of infrastructure and faculty development. This article presents findings from a site assessment inventory completed during the initial year of the ISPCTN. Methods: An assessment inventory was developed for surveying ISPCTN sites. The inventory captured site-level activities designed to increase clinical trial research …

The Prospect Of Nanoparticle Systems For Modulating Immune Cell Polarization During Central Nervous System Infection, Lee E. Korshoj, Wen Shi, Bin Duan, Tammy Kielian

Journal Articles: Pathology and Microbiology

The blood-brain barrier (BBB) selectively restricts the entry of molecules from peripheral circulation into the central nervous system (CNS) parenchyma. Despite this protective barrier, bacteria and other pathogens can still invade the CNS, often as a consequence of immune deficiencies or complications following neurosurgical procedures. These infections are difficult to treat since many bacteria, such as Staphylococcus aureus, encode a repertoire of virulence factors, can acquire antibiotic resistance, and form biofilm. Additionally, pathogens can leverage virulence factor production to polarize host immune cells towards an anti-inflammatory phenotype, leading to chronic infection. The difficulty of pathogen clearance is magnified by …

Patient-Reported Outcomes Through 1 Year Of An Hiv-1 Clinical Trial Evaluating Long-Acting Cabotegravir And Rilpivirine Administered Every 4 Or 8 Weeks (Atlas-2m), Vasiliki Chounta, Edgar T. Overton, Anthony Mills, Susan Swindells, Paul D. Benn, Simon Vanveggel, Rodica Van Solingen-Ristea, Yuanyuan Wang, Krischan J. Hudson, Mark S. Shaefer, David A. Margolis, Kimberly Y. Smith, William R. Spreen

Journal Articles: Infectious Diseases

BACKGROUND: Advances in HIV-1 therapeutics have led to the development of a range of daily oral treatment regimens, which share similar high efficacy rates. Consequently, more emphasis is being placed upon the individual's experience of treatment and impact on quality of life. The first long-acting injectable antiretroviral therapy for HIV-1 (long-acting cabotegravir + rilpivirine [CAB + RPV LA]) may address challenges associated with oral treatment for HIV-1, such as stigma, pill burden/fatigue, drug-food interactions, and adherence. Patient-reported outcomes (PROs) collected in an HIV-1 clinical trial (ATLAS-2M; NCT03299049) comparing participants' experience with two dosing regimens (every 4 weeks [Q4W] vs. every …

In Utero And Postnatal Oxycodone Exposure: Implications For Intergenerational Effects, Katherine E. Odegaard

Theses & Dissertations

Prescription opioid abuse during and after pregnancy is a rising public health concern. Adding a layer of complexity is the role of heredity in the overall development of these exposed offspring. The present work uses a preclinical rat model mimicking oxycodone (oxy) exposure in utero (IUO) and postnatally (PNO) to investigate comparative and intergenerational effects in the two different exposure groups.

To understand the direct effects of IUO and PNO exposure on the F1 generation, we employed a systems biology approach encompassing proton magnetic resonance spectroscopy (¹H-MRS), electrophysiology RNA-sequencing, and pain assessment to elucidate molecular and behavioral changes …

Development Of Long-Acting Antiviral Drug Nanoformulations, Denise Cobb

Theses & Dissertations

Antiretroviral therapy (ART) has improved the quality and duration of life for people living with human immunodeficiency virus (HIV) infection. However, opportunities to improve its profile abound. ART is limited by putative viral reservoir penetrance, emergence of viral mutations, inherent toxicities, and regimen non-adherence. These highlight the need improved drug delivery schemes. Previously, our lab has demonstrated that targeting mononuclear phagocytes for antiretroviral drug delivery extends drug half-life and improves penetrance into viral reservoirs, addressing these limitations of ART. Herein, we developed synthetic and biologic antiretroviral (ARV) drug nanocarriers improve the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of ARVs through …

Characterization Of Di-Aryl Urea Compounds Against Acute And Chronic Toxoplasma Gondii, Austin Sanford

Theses & Dissertations

Toxoplasma gondii is an obligate intracellular parasite that has infected nearly 60 million individuals in the United States alone. Acute infection causes ill effects to the fetus in utero when mothers are primarily infected, and to immunocompromised individuals. Chronic infection consists of quiescent tissue cysts located primarily in brain tissue and is capable of reverting back to the acute stage causing severe toxoplasma encephalitis in immunocompromised individuals. Current treatments for acute infection are lacking while there are no approved treatments for the clearance of chronic infection. The aim of this research was to evaluate a family of di-aryl urea compounds …

Multimodal Neuroimaging Of Hiv And Aging, Brandon Lew

Theses & Dissertations

HIV infection remains a significant contributor to disease burden, and with the success of antiretroviral therapies, the population of people with HIV is aging. A growing literature suggests a relationship between HIV-infection and a profile of age advancement, most notably in molecular studies of epigenetics. However, despite the widely-known high prevalence of HIV-related brain atrophy, functional deficits, and HIV-associated neurocognitive disorder (HAND), epigenetic age advancement has not been linked to HIV-related changes in neuroimaging metrics.

We applied three neuroimaging methods, structural MRI, resting state functional MRI, and resting state MEG, to study the brain structure and function of 121 virally-suppressed …

Clinical Consequences And Determinants Of False Positive Blood Cultures In Adult Hospitalized Patients, Sidra Liaquat

Theses & Dissertations

Blood cultures are the gold standard for detecting blood stream infections. However, in the US, 0.6-6% of all blood cultures get contaminated leading to adverse clinical outcomes such as unnecessarily prolonged hospital stay and antibiotic therapy. Using electronic medical records, we explored the clinical outcomes and patient-specific risk factors of contaminated blood cultures in an era where rapid blood culture testing was being utilized to provide blood culture results within hours. Rapid blood culture test results can help clinicians in early and more effective management of patients with contaminated blood cultures, thus improving clinical outcomes. We also studied the impact …

Fire Service Covid-19 Infection Prevention And Control Policy Comparison, Saaddedine Dichari

Theses & Dissertations

To date, there have been over 2.7 million deaths and more than 126 million cases attributed to the COVID-19 pandemic (JHU, 2021). This pandemic has affected nearly every aspect of daily life. Among those impacted are U.S. firefighters, as they provide many services beyond simply extinguishing structure fires and are frequently dual certified as emergency medical technicians. Many of the victims of this pandemic have relied on first responders to provide them with emergency medical care and hospital transport. When caring for these infected patients, firefighters have an increased risk of exposure and must be provided with adequate …

Marinopyrrole Derivatives As Putative Antiparasitic Molecules Promoting Initiation Of Programmed Cell Death In Toxoplasma Gondii, Matthew C. Martens

Theses & Dissertations

Toxoplasma gondii is a globally-distributed obligate intracellular parasite and the causative agent of toxoplasmosis in humans, a biphasic disease often culminating in lifelong chronic infection. Though often mild, toxoplasmosis can lead to severe clinical presentation in immunocompromised patients and developing fetuses. Current therapeutic options are severely limited, with a combinatorial pyrimethamine/sulfadiazine regimen acting as the current standard of care for toxoplasmosis; however, both of these compounds can elicit serious adverse reactions in patients, and, additionally, are only effective against the acute stage of infection. To address these limitations, screenings of several analogs derived from the marine natural product marinopyrrole A …

Influenza Surveillance: Comparative Analysis Of Influenza Cases Data In Nebraska, Anna Carpenter

Capstone Experience: Master of Public Health

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Alteration Of Perceptions Of Safety Before And After Fit Testing Among College Of Dentistry Students, Tanner H. Clark

Capstone Experience: Master of Public Health

The COVID-19 pandemic has changed how hospitals and healthcare academic programs operate. This change has restricted services provided as well as educational opportunities for those training to be in healthcare. Further, personal protective equipment (PPE) has been required to help protect workers potentially having contact with patients who may have COVID-19. Dentistry workers are at particularly high risk due to repeated and continuous aerosol generating procedures. Healthcare students have traditionally been restricted to areas with minimal risk during clinical experiences; however, with the exposure occurring ubiquitously, avoiding the risk is nearly impossible. There is no uniform inclusion of students in …

The Migration Of Carbapenem-Resistant Acinetobacter Baumannii From The Battlefields Of Iraq And Afghanistan To The Healthcare Facilities Of The Veterans Health Administration, Jeffery Rogers

Capstone Experience: Master of Public Health

Multidrug-resistant organisms (MDRO) pose a great threat to health across the globe. That threat is also felt in the Veterans Health Administration (VHA). Wounded warriors returning home from the battlefields of Iraq and Afghanistan may have brought with them MDROs, such as the bacterium Acinetobacter baumannii, as they have transitioned from military service into the VHA facilities. This study investigates the interconnectedness of military service in the Department of Defense (DoD) and a lifetime of care at VHA through a longitudinal tracking of a linked cohort of combat veterans with battlefield injuries and subsequent MDR infections of A. baumannii. …

Perceptions Of Pediatricians On The Sars-Cov2 Vaccine, Karl Khandalavala, Kari Simonsen, Jeffrey A. Robinson

Child Health Research Institute Pediatric Research Forum

Introduction: The novel SARs-CoV2 coronavirus has infected approximately 30,000,000 people in the USA. To date, approximately 146 million doses of SARs-CoV2 vaccines have been administered. Perceptions of rapid vaccine development have resulted in reported vaccine hesitancy and refusal. Though not currently FDA approved for use in pediatric populations, but pediatric vaccination may contribute to herd immunity. Previous study demonstrates that physician recommendations significantly impact perceptions of routine pediatric immunizations among parents. Given this historical data, this study aimed to describe the strength of recommendation by pediatricians for the SARs-CoV2 vaccine for pediatric patients and their parents.

Methods: A …

Case Study Of Nursing Home Residents: The Association Between Carbapenemase-Producing Enterobacteriaceae (Cpe) And Covid-19, Jordan Ranta

Capstone Experience: Master of Public Health

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The Effect Of Fiber And Omega-6:Omega-3 Fatty Acid Ratio On Asthma And Asthma-Related Symptoms In An Adult U.S. Population, Korie As Nelson

Capstone Experience: Master of Public Health

Asthma is one of the most common diseases in the world affecting more than 10% of adults in many westernized countries and 339 million globally. Studies have shown a positive association between increased dietary fiber and improvement in asthma-related inflammation. Omega-3 fatty acids have also been shown to help mitigate inflammation in general. No identified studies have looked at the synergistic effect of omega-3 and omega-6 fatty acids alone and as a ratio with fiber on asthma, lung function, and respiratory morbidities. A positive association could mean that dietary interventions of fiber and fatty acids could significantly improve asthma and …

Efficacy Of Vaccine Candidates Against Zika Infection And Congenital Zika Syndrome: A Systematic Review And Meta-Analysis, Hannah Lund

Capstone Experience: Master of Public Health

There have been previous reviews looking into the efficacy of vaccine candidates against Zika infection in non-humans primates, but there hasn’t been a review looking into the efficacy against Congenital Zika Syndrome (CZS).The aim of this project was to systematically review literature on efficacy of vaccine candidates against Zika infection and CZS. A protocol was developed following PRISMA guidelines. English articles published since 2015 were included. Clinical trials (CCTs) that compared the efficacy of four Zika virus vaccine candidates' (PIV, DNA, mRNA, and Adenovirus) against zika infection and CZS in human and non-human primate models were included. Grey literature and …

The Epidemiology Of Clostridioides Difficile In Nebraska - A Descriptive Study Between 2018-2020, Storm Keffer

Capstone Experience: Master of Public Health

Objectives: Clostridioides difficile (C. diff) is a common but challenging infection both financially and medically. Due to these difficulties, Clostridioides difficile infection (CDI) caused by C. diff is a mandatory reportable disease in Nebraska and as such has been a priority disease targeted by various disease control practices across many hospitals. All CDI laboratory results are reported electronically through the Nebraska Electronic Disease Surveillance System (NEDSS). However, capturing and conceptualizing the true burden of CDIs in Nebraska has not been adequately accomplished since monitoring of CDIs began. The objective of this study is to examine the trends of …

Impact Of Proton Pump Inhibitor Use On Effectiveness Of Immune Checkpoint Inhibitors In Advanced Cancer Patients, Ken Chen

Capstone Experience: Master of Public Health

Background: Gut microbiome plays a critical role in modulating therapeutic effect of immune checkpoint inhibitors (ICIs). Proton pump inhibitors (PPIs) may affect the gut microbiome by altering gut pH.

Objective: To evaluate if concurrent use of PPI 0-30 days before or after initiation of ICIs (nivolumab or pembrolizumab) is associated with poorer overall survival (OS) and progression-free survival (PFS) for patients with stage IV non-small cell lung cancer (NSCLC), melanoma, renal cell carcinoma, transitional cell carcinoma or head and neck squamous cell carcinoma compared with no PPI use.

Methods: This was a single-center retrospective cohort study of advanced cancer patients …

A Deeper Look: The Impacts Of Covid-19 Among Latinos In Omaha, Diana Molina

Capstone Experience: Master of Public Health

The COVID-19 pandemic has manifested worldwide distress, affecting the lives of all population groups. Racial disparities are evident as minority populations are being disproportionately affected by the impacts of COVID-19. Data indicate that the Latino population may experience more severe cases of COVID-19 and have a higher mortality rate. However, little is known about the effects that the pandemic is having on day-to-day life. Thus, the purpose of this study is to investigate COVID-19's impact on life aspects including employment situation, finances, mental health, and experiences of discrimination among the Omaha Latino community. A survey collected data from 311 participants …

Response To Correspondence On "Reproducibility Of Crispr-Cas9 Methods For Generation Of Conditional Mouse Alleles: A Multi-Center Evaluation", Channabasavaiah B. Gurumurthy, Aidan R. O'Brien, Rolen M. Quadros, John Adams, Pilar Alcaide, Shinya Ayabe, Johnathan Ballard, Surinder K. Batra, Marie-Claude Beauchamp, Kathleen A. Becker, Guillaume Bernas, David Brough, Francisco Carrillo-Salinas, Wesley Chan, Hanying Chen, Ruby Dawson, Victoria Demambro, Jinke D'Hont, Katharine Dibb, James D. Eudy, Lin Gan, Jing Gao, Amy Gonzales, Anyonya Guntur, Huiping Guo, Donald W. Harms, Anne Harrington, Kathryn E. Hentges, Neil Humphreys, Shiho Imai, Hideshi Ishii, Mizuho Iwama, Eric Jonasch, Michelle Karolak, Bernard Keavney, Nay-Chi Khin, Masamitsu Konno, Yuko Kotani, Yayoi Kunihiro, Imayavaramban Lakshmanan, Catherine Larochelle, Catherine B. Lawrence, Lin Li, Volkhard Lindner, Xian-De Liu, Gloria Lopez-Castejon, Andrew Loudon, Jenna Lowe, Loydie Jerome-Majeweska, Taiji Matsusaka, Hiromi Miura, Yoshiki Miyasaka, Benjamin Morpurgo, Katherine Motyl, Yo-Ichi Nabeshima, Koji Nakade, Toshiaki Nakashiba, Kenichi Nakashima, Yuichi Obata, Sanae Ogiwara, Mariette Ouellet, Leif Oxburgh, Sandra Piltz, Ilka Pinz, Moorthy P. Ponnusamy, David Ray, Ronald J. Redder, Clifford J. Rosen, Nikki Ross, Mark T. Ruhe, Larisa Ryzhova, Ane M. Salvador, Sabrina Shameen Alam, Radislav Sedlacek, Karan Sharma, Chad Smith, Katrien Staes, Lora Starrs, Fumihiro Sugiyama, Satoru Takahashi, Tomohiro Tanaka, Andrew Trafford, Yoshihiro Uno, Leen Vanhoutte, Frederique Vanrockeghem, Brandon J. Willis, Christian S. Wright, Yuko Yamauchi, Xin Yi, Kazuto Yoshimi, Xuesong Zhang, Yu Zhang, Masato Ohtsuka, Satyabrata Das, Daniel J. Garry, Tino Hochepied, Paul Thomas, Jan Parker-Thornburg, Antony D. Adamson, Atsushi Yoshiki, Jean-Francois Schmouth, Andrei Golovko, William R. Thompson, K C Kent Lloyd, Joshua A. Wood, Mitra Cowan, Tomoji Mashimo, Seiya Mizuno, Hao Zhu, Petr Kasparek, Lucy Liaw, Joseph M. Miano, Gaetan Burgio

Journal Articles: Pharmacology & Experimental Neuroscience

No abstract provided.

Multi-Level Considerations For Optimal Implementation Of Long-Acting Injectable Antiretroviral Therapy To Treat People Living With Hiv: Perspectives Of Health Care Providers Participating In Phase 3 Trials, Andrea Mantsios, Miranda Murray, Tahilin S. Karver, Wendy Davis, Noya Galai, Princy Kumar, Susan Swindells, U. Fritz Bredeek, Rafael Rubio García, Antonio Antela, Santiago Cenoz Gomis, Miguel Pascual Bernáldez, Maggie Czarnogorski, Krischan Hudson, Nicki Walters, Deanna Kerrigan

Journal Articles: Infectious Diseases

BACKGROUND: Long-acting injectable antiretroviral therapy (LA ART) has been shown to be non-inferior to daily oral ART, with high patient satisfaction and preference to oral standard of care in research to date, and has recently been approved for use in the United States and Europe. This study examined the perspectives of health care providers participating in LA ART clinical trials on potential barriers and solutions to LA ART roll-out into real world settings.

METHODS: This analysis draws on two data sources: (1) open-ended questions embedded in a structured online survey of 329 health care providers participating in the ATLAS-2 M …

Drug Susceptibility Patterns Of Mycobacterium Tuberculosis From Adults With Multidrug-Resistant Tuberculosis And Implications For A Household Contact Preventive Therapy Trial, Anne-Marie Demers, Soyeon Kim, Sara Mccallum, Kathleen Eisenach, Michael Hughes, Linda Naini, Alberto Mendoza-Ticona, Neeta Pradhan, Kim Narunsky, Selvamuthu Poongulali, Sharlaa Badal-Faesen, Caryn Upton, Elizabeth Smith, N Sarita Shah, Gavin Churchyard, Amita Gupta, Anneke Hesseling, Susan Swindells, Actg A5300/Impaact I2003 Phoenix Feasibility Study Team

Journal Articles: Internal Medicine

BACKGROUND: Drug susceptibility testing (DST) patterns of Mycobacterium tuberculosis (MTB) from patients with rifampicin-resistant tuberculosis (RR-TB) or multidrug-resistant TB (MDR-TB; or resistant to rifampicin and isoniazid (INH)), are important to guide preventive therapy for their household contacts (HHCs).

METHODS: As part of a feasibility study done in preparation for an MDR-TB preventive therapy trial in HHCs, smear, Xpert MTB/RIF, Hain MTBDRplus, culture and DST results of index MDR-TB patients were obtained from routine TB programs. A sputum sample was collected at study entry and evaluated by the same tests. Not all tests were performed on all specimens due to variations …