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High Treatment Failure and Default Rates for Patients with MDR TB in KwaZulu-Natal, South Africa, 2000–2003
- Publication Year :
- 2010
-
Abstract
- Multidrug-resistant tuberculosis (MDR-TB) has emerged as a significant public health threat in South Africa.To describe treatment outcomes and determine risk factors associated with unfavorable outcomes among MDR-TB patients admitted to the provincial TB referral hospital in KwaZulu-Natal Province, South Africa.Retrospective observational study of MDR-TB patients admitted from 2000 to 2003.Of 1209 MDR-TB patients with documented treatment outcomes, 491 (41%) were cured, 35 (3%) completed treatment, 208 (17%) failed treatment, 223 (18%) died and 252 (21%) defaulted. Of the total number of patients with known human immunodeficiency virus (HIV) status, 52% were HIV-infected. Treatment failure, death and default each differed in their risk factors. Greater baseline resistance (aOR 2.3-3.0), prior TB (aOR 1.7), and diagnosis in 2001, 2002 or 2003 (aOR 1.9-2.3) were independent risk factors for treatment failure. HIV co-infection was a risk factor for death (aOR 5.6), and both HIV (aOR 2.0) and male sex (aOR 1.9) were risk factors for treatment default.MDR-TB treatment outcomes in KwaZulu-Natal were substantially worse than those published from other MDR-TB cohorts. Interventions such as concurrent antiretroviral therapy and decentralized MDR-TB treatment should be considered to improve MDR-TB outcomes in this high HIV prevalence setting.
- Subjects :
- Adult
Male
Chi-Square Distribution
Time Factors
Antitubercular Agents
HIV Infections
Middle Aged
Risk Assessment
Article
Medication Adherence
South Africa
Young Adult
Logistic Models
Sex Factors
Risk Factors
Tuberculosis, Multidrug-Resistant
Odds Ratio
Prevalence
Humans
Female
Treatment Failure
Developing Countries
Program Evaluation
Retrospective Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.pmid..........2bf972711b6241b515ae437f63d68ff1