J I Ebonwu1, K S Tint, C Ihekweazu. 1. South African Field Epidemiology and Laboratory Training Programme, National Institute for Communicable Diseases, Sandringham, South Africa. jodimegwu@yahoo.com
Abstract
SETTING: Gauteng, South Africa. OBJECTIVE: To determine treatment uptake among newly diagnosed multidrug-resistant tuberculosis (MDR-TB) patients and risk markers for non-initiation of treatment. DESIGN: A cross-sectional study was conducted including all newly diagnosed MDR-TB patients in Gauteng Province, South Africa, in 2011. Socio-demographic and clinical characteristics of those who attended Sizwe Hospital, the designated MDR-TB hospital, were extracted from their medical records. District health offices provided data on patients not seen at Sizwe Hospital. Univariate and multivariate analysis were used to determine risk markers for non-initiation of treatment. RESULTS: Of the 942 newly diagnosed MDR-TB patients in Gauteng, only 593 (63%) initiated treatment. Of these, 70 (11.8%) did not maintain treatment up to the fourth month. Among the 349 (37%) who did not initiate treatment, 31.2% died and 46.4% could not be accounted for. Referral for laboratory diagnosis from hospitals, health district of the laboratory diagnosis, human immunodeficiency virus infection and place of residence were independently associated with non-initiation of MDR-TB treatment. CONCLUSION: Untreated patients continue to transmit MDR-TB in the community. These study findings highlight the need to identify and target the causes of non-initiation of treatment in specific settings.
SETTING: Gauteng, South Africa. OBJECTIVE: To determine treatment uptake among newly diagnosed multidrug-resistant tuberculosis (MDR-TB) patients and risk markers for non-initiation of treatment. DESIGN: A cross-sectional study was conducted including all newly diagnosed MDR-TBpatients in Gauteng Province, South Africa, in 2011. Socio-demographic and clinical characteristics of those who attended Sizwe Hospital, the designated MDR-TB hospital, were extracted from their medical records. District health offices provided data on patients not seen at Sizwe Hospital. Univariate and multivariate analysis were used to determine risk markers for non-initiation of treatment. RESULTS: Of the 942 newly diagnosed MDR-TBpatients in Gauteng, only 593 (63%) initiated treatment. Of these, 70 (11.8%) did not maintain treatment up to the fourth month. Among the 349 (37%) who did not initiate treatment, 31.2% died and 46.4% could not be accounted for. Referral for laboratory diagnosis from hospitals, health district of the laboratory diagnosis, human immunodeficiency virus infection and place of residence were independently associated with non-initiation of MDR-TB treatment. CONCLUSION: Untreated patients continue to transmit MDR-TB in the community. These study findings highlight the need to identify and target the causes of non-initiation of treatment in specific settings.
Authors: H D Shewade; K S Shringarpure; M Parmar; N Patel; S Kuriya; S Shihora; N Ninama; N Gosai; R Khokhariya; C Popat; H Thanki; B Modi; P Dave; R K Baxi; A M V Kumar Journal: Public Health Action Date: 2018-06-21
Authors: Rifqah A Roomaney; Victoria Pillay-van Wyk; Oluwatoyin F Awotiwon; Edward Nicol; Jané D Joubert; Debbie Bradshaw; Lyn A Hanmer Journal: J Am Med Inform Assoc Date: 2017-04-01 Impact factor: 4.497
Authors: Helen S Cox; Johnny F Daniels; Odelia Muller; Mark P Nicol; Vivian Cox; Gilles van Cutsem; Sizulu Moyo; Virginia De Azevedo; Jennifer Hughes Journal: Open Forum Infect Dis Date: 2015-02-26 Impact factor: 3.835
Authors: E Marais; C K Mlambo; J J Lewis; N Rastogi; T Zozio; M P Grobusch; A Duse; T Victor; R W Warren Journal: Infection Date: 2013-12-21 Impact factor: 3.553
Authors: Pren Naidoo; Elizabeth du Toit; Rory Dunbar; Carl Lombard; Judy Caldwell; Anne Detjen; S Bertel Squire; Donald A Enarson; Nulda Beyers Journal: PLoS One Date: 2014-07-31 Impact factor: 3.240