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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Spread of extensively drug-resistant tuberculosis in Kwazulu-Natal Province, South Africa
PLoS ONE, Volume 6, No. 5, Article e17513, Year 2011
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Description
Background: In 2005 a cluster of 53 HIV-infected patients with extensively drug-resistant tuberculosis (XDR-TB) was detected in the Msinga sub-district, the catchment area for the Church of Scotland Hospital (CoSH) in Tugela Ferry, in KwaZulu-Natal province (KZN), South Africa. KZN is divided into 11 healthcare districts. We sought to determine the distribution of XDR TB cases in the province in relation to population density. Methods: In this cross-sectional study, the KZN tuberculosis laboratory database was analysed. Results of all patients with a sputum culture positive for Mycobacterium tuberculosis from January 2006 to June 2007 were included. Drug-susceptibility test results for isoniazid, rifampicin, ethambutol, streptomycin, kanamycin and ofloxacin were available for all patients as well as the location of the hospital where their clinical diagnosis was made. Findings: In total, 20858 patients attending one of 73 hospitals or their adjacent clinics had cultures positive for M. tuberculosis. Of these, 4170 (20%) were MDR-TB cases. Four hundred and forty three (11%) of the MDR tuberculosis cases displayed the XDR tuberculosis susceptibility profile. Only 1429 (34%) of the MDR-TB patients were seen at the provincial referral hospital for treatment. The proportion of XDR-TB amongst culture-confirmed cases was highest in the Msinga sub-district (19.6%), followed by the remaining part of the Umzinyati district (5.9%) and the other 10 districts (1.1%). The number of hospitals with at least one XDR-TB case increased from 18 (25%) to 58 (80%) during the study period. Interpretation: XDR-TB is present throughout KZN. More than 65% of all diagnosed MDR-TB cases, including XDR-TB patients, were left untreated and likely remained in the community as a source of infection. © 2011 Moodley et al.
Authors & Co-Authors
Moodley, Prashini
South Africa, Durban
Africa Health Research Institute
South Africa, Pietermaritzburg
Kwazulu-natal Department of Health
Shah, N. Sarita
South Africa, Durban
Africa Health Research Institute
United States, New York
Albert Einstein College of Medicine of Yeshiva University
South Africa
Tugela Ferry Care and Research tf Cares Collaboration
Tayob, Nabihah
South Africa, Tygerberg
South African Medical Research Council
Connolly, Catherine Anne
South Africa, Tygerberg
South African Medical Research Council
Zetola, Nicola M.
United States, Philadelphia
University of Pennsylvania
Gandhi, Neel R.
South Africa, Durban
Africa Health Research Institute
United States, New York
Albert Einstein College of Medicine of Yeshiva University
South Africa
Tugela Ferry Care and Research tf Cares Collaboration
Friedland, Gerald H.
South Africa, Durban
Africa Health Research Institute
South Africa
Tugela Ferry Care and Research tf Cares Collaboration
United States, New Haven
Yale School of Medicine
Sturm, Adriaan Willem
South Africa, Durban
Africa Health Research Institute
South Africa, Pietermaritzburg
Kwazulu-natal Department of Health
Statistics
Citations: 41
Authors: 8
Affiliations: 7
Identifiers
Doi:
10.1371/journal.pone.0017513
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
South Africa