Process measure of FAST tuberculosis infection control demonstrates delay in likely effective treatment.

<h2>SETTING:</h2>The tuberculous infection control strategy, FAST (Find cases Actively, Separate safely and Treat effectively), recommends prompt initiation of likely effective anti-tuberculosis treatment informed by Xpert&reg; MTB/RIF results.<h2>OBJECTIVE:</h2>To describe FAST implementation at Quang Nam Provincial TB and Lung Disease Hospital (QNH), Tam Ky, Viet Nam, using time to initiation of effective TB treatment as a process measure.<h2>DESIGN:</h2>Hospital logs were used to calculate the time to likely effective treatment in patients with pulmonary TB (PTB) hospitalised during the study period.<h2>RESULTS:</h2>Between 1 January and 31 December 2016, of 858 patients treated for PTB, 493 (57.5&percnt;) received likely effective treatment. The median time to likely effective treatment was 3 days (interquartile range 2.0&ndash;6.0), with 213 (43.2&percnt;) patients receiving likely effective treatment within 2 days. Of 81 patients receiving likely effective treatment for drug-susceptible TB with a positive Xpert result as their initial in-patient diagnostic test, 64 (79.0&percnt;) received likely effective treatment within 2 days compared with 10 (5.7&percnt;) who were initially smear-negative then found to be Xpert-positive ( P &lt; 0.0001).<h2>CONCLUSIONS:</h2>A &lsquo;time to&apos; process measure of the FAST tuberculous infection control strategy indicates delays in the initiation of likely effective anti-tuberculosis treatment in a resource-limited hospital. Expanding access to Xpert may speed time to likely effective treatment.