{"doi":"10.1371/journal.pgph.0000180","title":"Integrating services for HIV and multidrug-resistant tuberculosis: A global cross-sectional survey among ART clinics in low- and middle-income countries","abstract":"Tuberculosis (TB) is the leading cause of death among PLHIV and multidrug-resistant-TB (MDR-TB) is associated with high mortality. We examined the management for adult PLHIV coinfected with MDR-TB at ART clinics in lower income countries. Between 2019 and 2020, we conducted a cross-sectional survey at 29 ART clinics in high TB burden countries within the global IeDEA network. We used structured questionnaires to collect clinic-level data on the TB and HIV services and the availability of diagnostic tools and treatment for MDR-TB. Of 29 ART clinics, 25 (86%) were in urban areas and 19 (66%) were tertiary care clinics. Integrated HIV-TB services were reported at 25 (86%) ART clinics for pan-susceptible TB, and 14 (48%) clinics reported full MDR-TB services on-site, i.e. drug susceptibility testing [DST] and MDR-TB treatment. Some form of DST was available on-site at 22 (76%) clinics, while the remainder referred testing off-site. On-site DST for second-line drugs was available at 9 (31%) clinics. MDR-TB treatment was delivered on-site at 15 (52%) clinics, with 10 individualizing treatment based on DST results and five using standardized regimens alone. Bedaquiline was routinely available at 5 (17%) clinics and delamanid at 3 (10%) clinics. Although most ART clinics reported having integrated HIV and TB services, few had fully integrated MDR-TB services. There is a continued need for increased access to diagnostic and treatment options for MDR-TB patients and better integration of MDR-TB services into the HIV care continuum.","journal":"PLOS Global Public Health","year":2022,"id":280630,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.957,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":326401,"name":"Samyra R. Cox","orcid":"0000-0001-9953-1693","position":1,"is_corresponding":false},{"id":424028,"name":"Marie Ballif","orcid":"0000-0003-3133-3011","position":2,"is_corresponding":false},{"id":333681,"name":"Leslie A. Enane","orcid":"0000-0001-8390-5881","position":3,"is_corresponding":false},{"id":424032,"name":"Olivier Marcy","orcid":"0000-0003-3350-112X","position":4,"is_corresponding":false},{"id":61432,"name":"Marcel Yotebieng","orcid":"0000-0003-2110-2631","position":5,"is_corresponding":false},{"id":407349,"name":"Gary Reubenson","orcid":"0000-0003-2541-4165","position":6,"is_corresponding":false},{"id":955511,"name":"Worarat Imsanguan","orcid":null,"position":7,"is_corresponding":false},{"id":231938,"name":"Larissa Otero","orcid":"0000-0002-8348-4340","position":8,"is_corresponding":false},{"id":326400,"name":"Nishi Suryavanshi","orcid":"0000-0001-8917-0302","position":9,"is_corresponding":false},{"id":64991,"name":"Stephany N. Duda","orcid":"0000-0001-6247-9350","position":10,"is_corresponding":false},{"id":4469,"name":"Matthias Egger","orcid":"0000-0001-7462-5132","position":11,"is_corresponding":false},{"id":333923,"name":"Jeffrey A. Tornheim","orcid":"0000-0002-1566-4622","position":12,"is_corresponding":false},{"id":424029,"name":"Lukas Fenner","orcid":"0000-0003-3309-4835","position":13,"is_corresponding":false},{"id":705839,"name":"International epidemiology Databases to Evaluate AIDS (IeDEA)","orcid":null,"position":14,"is_corresponding":false},{"id":424026,"name":"Kathrin Zürcher","orcid":"0000-0002-7915-3194","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-19T00:29:03.247347Z","pmid":"36778080","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}