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dc.contributor.author | Berry, Kaitlyn M.![]() |
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dc.contributor.author | Rodriguez, Carly A.![]() |
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dc.contributor.author | Berhanu, Rebecca H.![]() |
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dc.contributor.author | Ismail, Nazir Ahmed![]() |
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dc.contributor.author | Mvusi, Lindiwe![]() |
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dc.contributor.author | Long, Lawrence![]() |
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dc.contributor.author | Evans, Denise![]() |
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dc.date.accessioned | 2020-07-17T05:05:25Z | |
dc.date.available | 2020-07-17T05:05:25Z | |
dc.date.issued | 2019-07-22 | |
dc.description.abstract | BACKGROUND : Gauteng Province has the second lowest tuberculosis (TB) incidence rate in South Africa but the greatest proportion of TB/HIV co-infection, with 68% of TB patients estimated to have HIV. TB treatment outcomes are well documented at the national and provincial level; however, knowledge gaps remain on how outcomes differ across detailed age groups. METHODS : Using data from South Africa’s National Electronic TB Register (ETR), we assessed all-cause mortality and loss to follow-up (LTFU) among patients initiating treatment for TB between 01/2010 and 12/2015 in the metropolitan municipalities of Ekurhuleni Metropolitan Municipality and the City of Johannesburg in Gauteng Province. We excluded patients who were missing age, had known drug-resistance, or transferred into TB care from sites outside the two metropolitan municipalities. Among patients assigned a treatment outcome, we investigated the association between age group at treatment initiation and mortality or LTFU (treatment interruption of ≥2 months) within 10 months after treatment initiation using Cox proportional hazard models and present hazard ratios and Kaplan-Meier survival curves. RESULTS : We identified 182,890 children (<10 years), young adolescent (10–14), older adolescent (15–19), young adult (20–24), adult (25–49), and older adult (≥50) TB cases without known drug-resistance. ART coverage among HIV co-infected patients was highest for young adolescents (64.3%) and lowest for young adults (54.0%) compared to other age groups (all over 60%). Treatment success exceeded 80% in all age groups (n = 170,017). All-cause mortality increased with age. Compared to adults, young adults had an increased hazard of LTFU (20–24 vs 25–49 years; aHR 1.43 95% CI: 1.33, 1.54) while children, young adolescents, and older adults had lower hazard of LTFU. Patients with HIV on ART had a lower risk of LTFU, but greater risk of death when compared to patients without HIV. CONCLUSIONS : Young adults in urban areas of Gauteng Province experience a disproportionate burden of LTFU and low coverage of ART among co-infected patients. This group should be targeted for interventions aimed at improving clinical outcomes and retention in both TB and HIV care. | en_ZA |
dc.description.department | Medical Microbiology | en_ZA |
dc.description.librarian | am2020 | en_ZA |
dc.description.sponsorship | The American People and the President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID under the terms of Cooperative Agreements AID- 674-A-12-00029 and 72067419CA00004 to HE2RO. | en_ZA |
dc.description.uri | https://bmcpublichealth.biomedcentral.com | en_ZA |
dc.identifier.citation | Berry, K.M., Rodriguez, C.A., Berhanu, R.H. et al. 2019, 'Treatment outcomes among children, adolescents, and adults on treatment for tuberculosis in two metropolitan municipalities in Gauteng Province, South Africa', BMC Public Health, vol. 19, art. 973, pp. 1-17. | en_ZA |
dc.identifier.issn | 1471-2458 (online) | |
dc.identifier.other | 10.1186/s12889-019-7257-4 | |
dc.identifier.uri | http://hdl.handle.net/2263/75333 | |
dc.language.iso | en | en_ZA |
dc.publisher | BioMed Central | en_ZA |
dc.rights | © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. | en_ZA |
dc.subject | Pediatrics | en_ZA |
dc.subject | Adults | en_ZA |
dc.subject | Young adults | en_ZA |
dc.subject | Tuberculosis (TB) | en_ZA |
dc.subject | Gauteng Province, South Africa | en_ZA |
dc.subject | Electronic TB register (ETR) | en_ZA |
dc.subject | Loss to follow-up (LTFU) | en_ZA |
dc.subject | Outcomes | en_ZA |
dc.subject | Human immunodeficiency virus (HIV) | en_ZA |
dc.title | Treatment outcomes among children, adolescents, and adults on treatment for tuberculosis in two metropolitan municipalities in Gauteng Province, South Africa | en_ZA |
dc.type | Article | en_ZA |