Low treatment initiation rates among multidrug-resistant tuberculosis patients in Gauteng, South Africa, 2011
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Date
Authors
Ebonwu, J.I.
Tint, Khin-San
Ihekweazu, Chikwe
Journal Title
Journal ISSN
Volume Title
Publisher
International Union Against Tuberculosis and Lung Disease
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
Description
Keywords
MDR-TB transmission, Patient tracing, Untreated patients, Risk markers, Death
Sustainable Development Goals
Citation
Ebonwu, JI, Tint, KS & Ihekweazu, C 2013, 'Low treatment initiation rates among multidrug-resistant tuberculosis patients in Gauteng, South Africa, 2011', International Journal of Tuberculosis and Lung Disease, vol. 17, no. 8, pp. 1043-1048.