Loss from treatment for drug resistant tuberculosis: risk factors and patient outcomes in a community-based program in Khayelitsha, South Africa

PloS One
Sizulu MoyoGilles van Cutsem

Abstract

A community based drug resistant tuberculosis (DR-TB) program has been incrementally implemented in Khayelitsha, a high HIV and TB burden community in South Africa. We investigated loss from treatment (LFT), and post treatment outcomes of DR-TB patients in this setting. LFT, defined as interruption of treatment for ≥2 consecutive months was assessed among patients initiating DR-TB treatment for the first time between January 2009 and July 2011. Patients were traced through routine data sources to identify those who subsequently restarted treatment and those who died. Additional information on patient status and survival after LTF was obtained from community DR-TB counselors and from the national death registry. Post treatment outcomes were observed until July 2013. Among 452 patients initiating treatment for the first time within the given period, 30% (136) were LFT, with 67% retention at 18 months. Treatment was restarted in 27 (20%) patients, with additional resistance recorded in 2/25 (8%), excluding two with presumed DR-TB. Overall, 34 (25%) patients died, including 11 who restarted treatment. Males and those in the age category 15-25 years had a greater hazard of LFT; HR 1.93 (95% CI 1.35-2.75), and 2.43 (95% CI 1.52-3.88)...Continue Reading

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Citations

Mar 21, 2019·The Cochrane Database of Systematic Reviews·Bhagteshwar SinghDerek J Sloan
Nov 9, 2017·The Journal of Infectious Diseases·Pren NaidooYogan Pillay
Jul 22, 2019·Antibiotics·Monadil H AliBrian Godman
Mar 13, 2021·BMC Public Health·Lesley-Ann Lynnath CannonDaniel Ter Goon

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