Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Comparing early treatment outcomes of MDR-TB in decentralised and centralised settings in KwaZulu-Natal, South Africa
International Journal of Tuberculosis and Lung Disease, Volume 16, No. 2, Year 2012
Notification
URL copied to clipboard!
Description
SETTING: In KwaZulu-Natal, South Africa, a setting endemic for tuberculosis (TB) and the human immunodeficiency virus (HIV), prolonged hospitalisation for the treatment of the growing number of multidrug-resistant TB (MDR-TB) patients is neither possible nor effective. OBJECTIVE: To compare early treatment outcomes in patients with MDR-TB with and without HIV coi nfection at four decentralised rural sites with a central urban referral hospital. DESIGN: This is an operational, prospective cohort study of patients between 1 July 2008 and 30 November 2009, where culture conversion, time to culture conversion, survival and predictors of these outcomes were analysed. RESULTS: Of 860 patients with MDR-TB, 419 were at the decentralised sites and 441 at the central hospital. Overall, 71% were HIV co-infected. In the 17-month study period, there was a higher proportion of culture conversion at the decentralised sites compared with the centralised hospital (54% vs. 24%, P < 0.001, OR 3.76, 95%CI 2.81-5.03). The median time to treatment initiation was significantly shorter at the decentralised sites compared with the centralised hospital (72 vs. 93 days, P < 0.001). There was no significant difference in survival following treatment initiation. CONCLUSION: In this study, early treatment outcomes suggest that decentralised care for MDR-TB patients is superior to that in a centralised setting. © 2012 The Union.
Authors & Co-Authors
Loveday, Marian
South Africa, Tygerberg
South African Medical Research Council
South Africa, Durban
The Nelson R. Mandela Medical School
Wallengren, Kristina
South Africa, Durban
Africa Health Research Institute
Voce, Anna Silvia
South Africa, Durban
The Nelson R. Mandela Medical School
Margot, Bruce
South Africa, Pietermaritzburg
Kwazulu-natal Department of Health
Reddy, Tarylee
South Africa, Tygerberg
South African Medical Research Council
Master, Iqbal M.
South Africa, Pietermaritzburg
Kwazulu-natal Department of Health
Brust, James C.M.
United States, New York
Albert Einstein College of Medicine of Yeshiva University
Chaiyachati, Krisda
United States, Ann Arbor
University of Michigan Medical School
United States, Cambridge
Harvard University
Padayatchi, Nesri
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Statistics
Citations: 61
Authors: 9
Affiliations: 8
Identifiers
Doi:
10.5588/ijtld.11.0401
ISSN:
10273719
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa