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Loss from treatment for drug resistant tuberculosis: risk factors and patient outcomes in a community-based program in Khayelitsha, South Africa

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dc.date.accessioned 2015-03-25 en
dc.date.accessioned 2021-02-09T15:25:08Z
dc.date.available 2021-02-09T15:25:08Z
dc.date.issued 2015-08-25 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/2001
dc.description.abstract A community based drug resistant tuberculosis (DR-TB) program has been incrementally implemented in Khayelitsha, a high HIV and TB burden community in South Africa. We investigated loss from treatment (LFT), and post treatment outcomes of DR-TB patients in this setting. LFT, defined as interruption of treatment for 2 consecutive months was assessed among patients initiating DR-TB treatment for the first time between January 2009 and July 2011. Patients were traced through routine data sources to identify those who subsequently restarted treatment and those who died. Additional information on patient status and survival after LTF was obtained from community DR-TB counselors and from the national death registry. Post treatment outcomes were observed until July 2013. Among 452 patients initiating treatment for the first time within the given period, 30% (136) were LFT, with 67% retention at 18 months. Treatment was restarted in 27 (20%) patients, with additional resistance recorded in 2/25 (8%), excluding two with presumed DR-TB. Overall, 34 (25%) patients died, including 11 who restarted treatment. Males and those in the age category 15-25 years had a greater hazard of LFT; HR 1.93 (95% CI 1.35-2.75), and 2.43 (95% CI 1.52-3.88) respectively. Older age (>35 years) was associated with a greater hazard of death; HR 3.74 (1.13- 12.37) post treatment. LFT was high, occurred throughout the treatment period and was particularly high among males and those aged 15-25 years. Overall long term survival was poor. High rates of LFT should however not preclude scale up of community based care given its impact in increasing access to treatment. Further research is needed to support retention of DR-TB patients on treatment, even within community based treatment programs. en
dc.format.medium Print en
dc.subject RISK BEHAVIOUR en
dc.subject TUBERCULOSIS en
dc.subject COMMUNITY BASED CARE en
dc.subject KHAYELITSHA en
dc.title Loss from treatment for drug resistant tuberculosis: risk factors and patient outcomes in a community-based program in Khayelitsha, South Africa en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber N/A en
dc.Volume 10(3) en
dc.BudgetYear 2014/15 en
dc.ResearchGroup HIV/AIDS, STIs and TB en
dc.SourceTitle PLoS One en
dc.ArchiveNumber 8587 en
dc.URL http://ktree.hsrc.ac.za/doc_read_all.php?docid=15604 en
dc.PageNumber Online en
dc.outputnumber 7355 en
dc.bibliographictitle Moyo, S., Cox, H.S., Hughes, J., Daniels, J., Synman, L., De Azevedo, V., Shroufi, A., Cox, V. & Van Cutsem, G. (2015) Loss from treatment for drug resistant tuberculosis: risk factors and patient outcomes in a community-based program in Khayelitsha, South Africa. <i>PLoS One</i>. 10(3):Online. http://hdl.handle.net/20.500.11910/2001 en
dc.publicationyear 2015 en
dc.contributor.author1 Moyo, S. en
dc.contributor.author2 Cox, H.S. en
dc.contributor.author3 Hughes, J. en
dc.contributor.author4 Daniels, J. en
dc.contributor.author5 Synman, L. en
dc.contributor.author6 De Azevedo, V. en
dc.contributor.author7 Shroufi, A. en
dc.contributor.author8 Cox, V. en
dc.contributor.author9 Van Cutsem, G. en


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