Rifampicin resistant tuberculosis in Lesotho : diagnosis, treatment initiation and outcomes

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dc.contributor.advisorWarren, Robin Marken_ZA
dc.contributor.authorKatende, Bulembaen_ZA
dc.contributor.authorEsterhuizen, Tonyaen_ZA
dc.contributor.authorDippenaar, Anzaanen_ZA
dc.contributor.authorWarren, Robinen_ZA
dc.date.accessioned2019-11-25T18:37:11Z
dc.date.accessioned2019-12-11T06:38:31Z
dc.date.available2019-11-25T18:37:11Z
dc.date.available2019-12-11T06:38:31Z
dc.date.issued2019-12
dc.descriptionGlobal Health: Epidemiology and Biostatisticsen_ZA
dc.descriptionCITATION: Katende, B., Esterhuizen, T.M., Dippenaar, A. et al. 2020. Rifampicin Resistant Tuberculosis in Lesotho: Diagnosis, Treatment Initiation and Outcomes. Sci Rep 10, 1917 (2020). https://doi.org/10.1038/s41598-020-58690-4en_ZA
dc.descriptionThe original publication is available at: http://www.nature.com/srep/index.htmlen_ZA
dc.description.abstractThe Lesotho guidelines for the management of drug-resistant tuberculosis (TB) recommend initiation of patients diagnosed with rifampicin resistant (RR)-TB on a standardized drug resistant regimen while awaiting confirmation of rifampicin resistant TB (RR-TB) and complete drug susceptibility test results. Review of diagnostic records between 2014 and 2016 identified 518 patients with RR-TB. Only 314 (60.6%) patients could be linked to treatment records at the Lesotho MDR hospital. The median delay in treatment initiation from the availability of Xpert MTB/RIF assay result was 12 days (IQR 7–19). Only 32% (101) of patients had a documented first-line drug resistant test. MDR-TB was detected in 56.4% of patients while 33.7% of patients had rifampicin mono-resistance. Only 7.4% of patients assessed for second-line resistance had a positive result (resistance to fluoroquinolone). Treatment success was 69.8%, death rate was 28.8%, loss to follow up was 1.0%, and 0.4% failed treatment. Death was associated with positive or unavailable sputum smear at the end of first month of treatment (Fisher exact p < 0.001) and older age (p = 0.007). Urgent attention needs to be given to link patients with RR-TB to care worldwide. The association of death rate with positive sputum smear at the end of the first month of treatment should trigger early individualization of treatment.en_ZA
dc.description.versionMasters
dc.description.versionPre print
dc.description.versionPublisher’s versionen_ZA
dc.format.extent1-8 Pagesen_ZA
dc.identifier.citationKatende, B., Esterhuizen, T.M., Dippenaar, A. et al. 2020. Rifampicin Resistant Tuberculosis in Lesotho: Diagnosis, Treatment Initiation and Outcomes. Sci Rep 10, 1917 (2020). https://doi.org/10.1038/s41598-020-58690-4en_ZA
dc.identifier.issn2045-2322 (Online)en_ZA
dc.identifier.otherdoi.org/10.1038/s41598-020-58690-4en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/106911
dc.language.isoen_ZAen_ZA
dc.publisherNature Research [Commercial Publisher]en_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectTuberculosisen_ZA
dc.subjectrifampicin resistanceen_ZA
dc.subjectXpert MTB/RIFen_ZA
dc.subjectLesothoen_ZA
dc.titleRifampicin resistant tuberculosis in Lesotho : diagnosis, treatment initiation and outcomesen_ZA
dc.typeArticleen_ZA
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