Evaluation of Drug-resistant Tuberculosis Treatment Outcome in Limpopo Province, South Africa

Overview

Journal Afr J Prim Health Care Fam Med

Specialty Public Health

Date 2023 Aug 1

PMID 37526555

Authors

Ngwanamohuba M Seloma

Marema E Makgatho

Eric Maimela

Affiliations

Soon will be listed here.

Abstract

Background: South Africa has the second-highest tuberculosis (TB) incidence globally. Drug-resistant TB (DR-TB) treatment has less successful treatment outcomes as compared with susceptible TB, and it hinders TB control and management programmes.

Aim: This study aimed to evaluate drug-resistant TB treatment outcomes and factors associated with successful treatment outcomes.

Setting: The study was conducted in five districts in Limpopo province.

Methods: The study design was retrospective and descriptive. Patients' demographic data, data on clinical characteristics and treatment outcomes data were extracted from the electronic drug-resistant tuberculosis register (EDRWeb) database system for the period, 2010-2018, in Limpopo province. Frequency, percentages and bivariate and multivariate logistic regression were used to analyse data using Statistical Package for Social Sciences version 27.0. The significance difference was determined at a 95% confidence interval and p 0.05.

Results: A total of 385 drug-resistant records were included in this study. The treatment success rate was 223 (57.9%). A total of 197 (51.2%) patients were cured, 26 (6.8%) completed treatment, 19 (4.9%) treatment failure, 62 (16.1%) died, 78 (20.6%) were recorded as the loss to follow-up, 1 (0.3%) moved to another country and 2 (0.5%) were transferred out.

Conclusion: The treatment success rate was 57.9%, which is still below targets set by National Strategic Plan in South Africa and World Health Organization End TB targets.Contribution: The findings of the study reveal that to achieve successful DR-TB control programme and attain End TB targets, monitoring of treatment outcomes is crucial.

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References

Mazza-Stalder J, Chevallier E, Opota O, Carreira A, Jaton K, Masserey E . Improvement in Tuberculosis Outcomes With a Combined Medical and Social Approach. Front Med (Lausanne). 2019; 6:135. PMC: 6611410. DOI: 10.3389/fmed.2019.00135. View

Tola A, Minshore K, Ayele Y, Mekuria A . Tuberculosis Treatment Outcomes and Associated Factors among TB Patients Attending Public Hospitals in Harar Town, Eastern Ethiopia: A Five-Year Retrospective Study. Tuberc Res Treat. 2019; 2019:1503219. PMC: 6463571. DOI: 10.1155/2019/1503219. View

Mengesha M, Gebremichael M, Watumo D, Hallstrom I, Jerene D . Poor adult tuberculosis treatment outcome and associated factors in Gibe Woreda, Southern Ethiopia: An institution-based cross-sectional study. PLOS Glob Public Health. 2023; 2(3):e0000161. PMC: 10021194. DOI: 10.1371/journal.pgph.0000161. View

Tanue E, Nsagha D, Njamen T, Assob N . Tuberculosis treatment outcome and its associated factors among people living with HIV and AIDS in Fako Division of Cameroon. PLoS One. 2019; 14(7):e0218800. PMC: 6667204. DOI: 10.1371/journal.pone.0218800. View

Cox H, Mbhele S, Mohess N, Whitelaw A, Muller O, Zemanay W . Impact of Xpert MTB/RIF for TB diagnosis in a primary care clinic with high TB and HIV prevalence in South Africa: a pragmatic randomised trial. PLoS Med. 2014; 11(11):e1001760. PMC: 4244039. DOI: 10.1371/journal.pmed.1001760. View

Oliveira O, Gaio R, Correia-Neves M, Rito T, Duarte R . Evaluation of drug-resistant tuberculosis treatment outcome in Portugal, 2000-2016. PLoS One. 2021; 16(4):e0250028. PMC: 8057584. DOI: 10.1371/journal.pone.0250028. View

Ndjeka N, Hughes J, Reuter A, Conradie F, Enwerem M, Ferreira H . Implementing novel regimens for drug-resistant TB in South Africa: what can the world learn?. Int J Tuberc Lung Dis. 2020; 24(10):1073-1080. DOI: 10.5588/ijtld.20.0174. View

Schnippel K, Berhanu R, Black A, Firnhaber C, Maitisa N, Evans D . Severe adverse events during second-line tuberculosis treatment in the context of high HIV Co-infection in South Africa: a retrospective cohort study. BMC Infect Dis. 2016; 16(1):593. PMC: 5073931. DOI: 10.1186/s12879-016-1933-0. View

Trebucq A, Schwoebel V, Kashongwe Z, Bakayoko A, Kuaban C, Noeske J . Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries. Int J Tuberc Lung Dis. 2017; 22(1):17-25. DOI: 10.5588/ijtld.17.0498. View

10.

Murdoch J, Curran R, J van Rensburg A, Awotiwon A, Dube A, Bachmann M . Identifying contextual determinants of problems in tuberculosis care provision in South Africa: a theory-generating case study. Infect Dis Poverty. 2021; 10(1):67. PMC: 8108019. DOI: 10.1186/s40249-021-00840-5. View

11.

Tesema T, Seyoum D, Ejeta E, Tsegaye R . Determinants of tuberculosis treatment outcome under directly observed treatment short courses in Adama City, Ethiopia. PLoS One. 2020; 15(4):e0232468. PMC: 7190142. DOI: 10.1371/journal.pone.0232468. View

12.

Izudi J, Tamwesigire I, Bajunirwe F . Sputum smear non-conversion among adult persons with bacteriologically confirmed pulmonary tuberculosis in rural eastern Uganda. J Clin Tuberc Other Mycobact Dis. 2020; 20:100168. PMC: 7283142. DOI: 10.1016/j.jctube.2020.100168. View

13.

Nkurunziza J, Karstaedt A, Louw R, Padanilam X . Treatment outcomes of pre- and extensively drug-resistant tuberculosis in Johannesburg, South Africa. Int J Tuberc Lung Dis. 2019; 22(12):1469-1474. DOI: 10.5588/ijtld.18.0205. View

14.

Budgell E, Evans D, Schnippel K, Ive P, Long L, Rosen S . Outcomes of treatment of drug-susceptible tuberculosis at public sector primary healthcare clinics in Johannesburg, South Africa: A retrospective cohort study. S Afr Med J. 2016; 106(10):1002-1009. DOI: 10.7196/SAMJ.2016.v106i10.10745. View

15.

Melese A, Zeleke B . Factors associated with poor treatment outcome of tuberculosis in Debre Tabor, northwest Ethiopia. BMC Res Notes. 2018; 11(1):25. PMC: 5769532. DOI: 10.1186/s13104-018-3129-8. View

16.

Nair D, Velayutham B, Kannan T, Tripathy J, Harries A, Natrajan M . Predictors of unfavourable treatment outcome in patients with multidrug-resistant tuberculosis in India. Public Health Action. 2017; 7(1):32-38. PMC: 5526484. DOI: 10.5588/pha.16.0055. View

17.

Getie A, Alemnew B . Tuberculosis Treatment Outcomes and Associated Factors Among Patients Treated at Woldia General Hospital in Northeast Ethiopia: An Institution-Based Cross-Sectional Study. Infect Drug Resist. 2020; 13:3423-3429. PMC: 7547773. DOI: 10.2147/IDR.S275568. View

18.

Mabunda T, Ramalivhana N, Dambisya Y . Mortality associated with tuberculosis/HIV co-infection among patients on TB treatment in the Limpopo province, South Africa. Afr Health Sci. 2015; 14(4):849-54. PMC: 4370064. DOI: 10.4314/ahs.v14i4.12. View

19.

Calderwood C, Wilson J, Fielding K, Harris R, Karat A, Mansukhani R . Dynamics of sputum conversion during effective tuberculosis treatment: A systematic review and meta-analysis. PLoS Med. 2021; 18(4):e1003566. PMC: 8109831. DOI: 10.1371/journal.pmed.1003566. View

20.

El Hamdouni M, Bourkadi J, Benamor J, Hassar M, Cherrah Y, Ahid S . Treatment outcomes of drug resistant tuberculosis patients in Morocco: multi-centric prospective study. BMC Infect Dis. 2019; 19(1):316. PMC: 6458640. DOI: 10.1186/s12879-019-3931-5. View