Loss from treatment for drug resistant tuberculosis: risk factors and patient outcomes in a community-based program in Khayelitsha, South Africa
SOURCE: PLoS One
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2015
TITLE AUTHOR(S): S.Moyo, H.S.Cox, J.Hughes, J.Daniels, L.Synman, V.De Azevedo, A.Shroufi, V.Cox, G.Van Cutsem
KEYWORDS: CARE IN THE COMMUNITY, KHAYELITSHA, RISK BEHAVIOUR, TUBERCULOSIS
DEPARTMENT: Public Health, Societies and Belonging (HSC)
Print: HSRC Library: shelf number 8587
HANDLE: 20.500.11910/2001
URI: http://hdl.handle.net/20.500.11910/2001
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2015
TITLE AUTHOR(S): S.Moyo, H.S.Cox, J.Hughes, J.Daniels, L.Synman, V.De Azevedo, A.Shroufi, V.Cox, G.Van Cutsem
KEYWORDS: CARE IN THE COMMUNITY, KHAYELITSHA, RISK BEHAVIOUR, TUBERCULOSIS
DEPARTMENT: Public Health, Societies and Belonging (HSC)
Print: HSRC Library: shelf number 8587
HANDLE: 20.500.11910/2001
URI: http://hdl.handle.net/20.500.11910/2001
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
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) respectively. Older age (>35 years) was associated with a greater hazard of death; HR 3.74 (1.13- 12.37) post treatment. LFT was high, occurred throughout the treatment period and was particularly high among males and those aged 15-25 years. Overall long term survival was poor. High rates of LFT should however not preclude scale up of community based care given its impact in increasing access to treatment. Further research is needed to support retention of DR-TB patients on treatment, even within community based treatment programs.-
Related Research Outputs:
- Perceptions of tuberculosis: attributions of cause, suggested means of risk reduction, and preferred treatment in the Limpopo province, South Africa
- Hazardous and harmful alcohol use and associated factors in tuberculosis public primary care patients in South Africa
- Prevalence of post-traumatic stress symptoms and associated factors in tuberculosis (TB), TB retreatment and/or TB-HIV co-infected primary public health-care patients in three districts in South Africa
- HIV risk behaviour among public primary healthcare patients with tuberculosis in South Africa
- Prevalence and associated factors of tuberculosis treatment outcome among hazardous or harmful alcohol users in public primary health care in South Africa
- Concerns over the lack of knowledge about TB and HIV co-infection
- Role of oral candidiasis in TB and HIV co-infection: AIDS clinical trial group protocol A5253
- Drug-resistant TB treatment: concerns over absconding patients
- Programmatic treatment outcomes in HIV-infected and uninfected drug-resistant TB patients in Khayelitsha, South Africa
- Correlates of tobacco use among tuberculosis patients in South Africa: a brief report
- Trends in HIV testing and associated factors among men in South Africa: evidence from 2005, 2008 and 2012 national population-based household surveys
- Tuberculosis risk factors in Lephalale local municipality of Limpopo province, South Africa
- Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa
- Investigating the association between TB transmission and socio-economic risk factors in a high TB and HIV burdened community in Cape Town, South Africa
- Pathways to violence propensity: results from a two-wave study of young males in urban South Africa
- Feasibility of implementing the advanced HIV disease care package as part of community-based HIV/TB activities: a mixed-methods study protocol
- Prevalence of bacteriologically confirmed pulmonary tuberculosis in South Africa, 2017-19: a multistage, cluster-based, cross-sectional survey
- Task oriented nursing in a tuberculosis control programme in South Africa: where does it come from and what keeps it going?
- Abstract: Determinants of the use of voluntary counselling and testing services among the sexually active adult population of South Africa
- Preventive health behavior, personality and religiosity among black and white South Africans