Collins Timire1, Charles Sandy2, Ajay M V Kumar3, Mkhokheli Ngwenya4, Barbara Murwira2, Kudakwashe C Takarinda5, Anthony D Harries6. 1. Ministry of Health and Child Care, National AIDS & TB Control Program, Harare, Zimbabwe; International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; The Union, Harare, Zimbabwe. Electronic address: collinstimire2005@yahoo.com. 2. Ministry of Health and Child Care, National AIDS & TB Control Program, Harare, Zimbabwe. 3. International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; The Union, South-East Asia Office, New Delhi, India; Yenepoya Medical College, Yenepoya (Deemed To Be University), Mangaluru, India. 4. World Health Organisation, Harare Country Office, Zimbabwe. 5. Ministry of Health and Child Care, National AIDS & TB Control Program, Harare, Zimbabwe; International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; The Union, Harare, Zimbabwe. 6. International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; London School of Hygiene and Tropical Medicine, London, UK.
Abstract
OBJECTIVES: To determine the proportion of rifampicin-resistant tuberculosis (RR-TB) patients who accessed second-line drug susceptibility testing (SL-DST) results following introduction of the Hain technology in southern provinces, Zimbabwe. DESIGN: Cohort study using secondary data. RESULTS: Xpert MTB/RIF results were used to identify 133 RR-TB patients for this study. Their mean age (SD) was 37.9 (11.1) years, 83 (62%) were males and 106 (80%) were HIV-infected. There were 6 (5%) participants who had pre-treatment attrition. Of the 133 pulmonary TB (PTB) patients, 117 (80%) had additional sputum specimens collected; 96 (72%) specimens reached the National TB Reference Laboratory (NTBRL); 95 (71%) were processed; 68 (51%) had SL-DST results. Only 53 (40%) SL-DST results reached the peripheral facilities. Median time from specimen reception at the NTBRL to SL-DSTs was 40 days, interquartile range (IQR: 28-67). Median time from presumptive diagnosis of RR-TB by health care worker to SL-DST results was 50days (IQR: 39-80), and increased to 79days (IQR: 39-101) in facilities >250km from the NTBRL. The proportion with any fluoroquinolone resistance was 9 (13.2%). CONCLUSION: Although RR-TB patients with PTB were initiated timely on treatment, access to SL-DSTs by facilities needs improvement. Health inequities exist as remote areas are less likely to get SL-DST results in time.
OBJECTIVES: To determine the proportion of rifampicin-resistant tuberculosis (RR-TB) patients who accessed second-line drug susceptibility testing (SL-DST) results following introduction of the Hain technology in southern provinces, Zimbabwe. DESIGN: Cohort study using secondary data. RESULTS: Xpert MTB/RIF results were used to identify 133 RR-TB patients for this study. Their mean age (SD) was 37.9 (11.1) years, 83 (62%) were males and 106 (80%) were HIV-infected. There were 6 (5%) participants who had pre-treatment attrition. Of the 133 pulmonary TB (PTB) patients, 117 (80%) had additional sputum specimens collected; 96 (72%) specimens reached the National TB Reference Laboratory (NTBRL); 95 (71%) were processed; 68 (51%) had SL-DST results. Only 53 (40%) SL-DST results reached the peripheral facilities. Median time from specimen reception at the NTBRL to SL-DSTs was 40 days, interquartile range (IQR: 28-67). Median time from presumptive diagnosis of RR-TB by health care worker to SL-DST results was 50days (IQR: 39-80), and increased to 79days (IQR: 39-101) in facilities >250km from the NTBRL. The proportion with any fluoroquinolone resistance was 9 (13.2%). CONCLUSION: Although RR-TB patients with PTB were initiated timely on treatment, access to SL-DSTs by facilities needs improvement. Health inequities exist as remote areas are less likely to get SL-DST results in time.
Authors: K Zvinoera; I D Olaru; P Khan; J Mutsvangwa; C M Denkinger; V Kampira; D Coutinho; H Mutunzi; M Pepukai; E Chikaka; S Zinyowera; S Mharakurwa; K Kranzer Journal: Public Health Action Date: 2021-12-21
Authors: Charity Oga-Omenka; Florence Bada; Aderonke Agbaje; Patrick Dakum; Dick Menzies; Christina Zarowsky Journal: Int J Equity Health Date: 2020-12-10
Authors: J Chirenda; B Nhlema Simwaka; C Sandy; K Bodnar; S Corbin; P Desai; T Mapako; S Shamu; C Timire; E Antonio; A Makone; A Birikorang; T Mapuranga; M Ngwenya; T Masunda; M Dube; E Wandwalo; L Morrison; R Kaplan Journal: BMC Health Serv Res Date: 2021-03-18 Impact factor: 2.655