Factors influencing specialist care referral of multidrug- and extensively drug-resistant tuberculosis patients in Gauteng/South Africa : a descriptive questionnaire-based study
Loading...
Date
Authors
Nkosi, Deliwe
Janssen, Saskia
Padanilam, Xavier
Louw, Rianna
Menezes, Colin N.
Grobusch, Martin P.
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
BACKGROUND: Sizwe Tropical Diseases Hospital is the only specialized hospital for the management of
multidrug-resistant (MDR)-TB and extensively drug-resistant (XDR)-TB cases in Gauteng Province. In South
Africa, there is a mismatch between numbers of individuals with a laboratory diagnosis of drug-resistant
tuberculosis (TB) and those being referred for the initiation of specialist treatment. We determined reasons for
non-referral of MDR-TB and XDR-TB cases.
METHODS: We conducted a descriptive questionnaire-based study amongst provincial primary health care
facilities (PHC) and hospitals providing routine care for (drug-susceptible) TB, regarding specialist care referral
of patients whose TB culture and susceptibility testing confirmed MDR-TB or XDR-TB diagnoses in the first
half of 2008.
RESULTS: In total 148 cases were analyzed; 144/148 (97%) had MDR-TB and 4/148 (3%) had XDR-TB. The main
reason for non-referral to specialist care was loss to follow up, for patients diagnosed in-hospital (74/97; 76%)
as well as in PHCs (11/21; 52%). Nineteen per cent (18/97) of patients diagnosed in hospital versus 33% (7/21)
of patients diagnosed in PHCs deceased before referral.
CONCLUSIONS: A significant problem in the fight to control DR-TB is follow-up after diagnosis with a delay in
patient tracing. TB Focal Points in hospital need to be strengthened in order to improve on patient follow-up
and care, and tracer teams should assist with community follow up.
Description
Keywords
Delay of referral, Drug-resistant tuberculosis (DR-TB), Multidrug-resistant tuberculosis (MDR-TB), Extensively drug-resistant tuberculosis (XDR-TB)
Sustainable Development Goals
Citation
Nkosi et al.: Factors influencing specialist care referral of multidrug- and extensively drug-resistant tuberculosis patients in Gauteng/South Africa: a descriptive questionnaire-based study. BMC Health Services Research 2013 13:268.