The 5-year outcome of multidrug resistant tuberculosis patients in the Cape Province of South Africa

Date
1996
Authors
Schaaf H.S.
Botha P.
Beyers N.
Gie R.P.
Vermeulen H.A.S.
Groenewald P.
Coetzee G.J.
Donald P.R.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Little is known about the outcome of multidrug resistant (MDR) tuberculosis (TB) in developing countries. In this study, 443 patients with MDR-TB, defined as resistance to two Or more antituberculosis drugs, were identified over the 2-year period 1987 and 1988 in the Cape Province of South Africa. The 5-year outcome of the 343 (77%) patients that could be traced by questionnaire was evaluated retrospectively during 1992 and 1993 Of these, 240 (70%) were resistant to both isoniazid (H) and rifampicin (R) with or without resistance to other first-line antituberculosis drugs and 103 (30%) were resistant to H or R and/or other antituberculosis drugs. Mortality was 116 (48%) and 28 (27%) in these groups respectively with a significantly greater risk of death in the first group. Only 114 (33%) of all the MDR-TB patients were cured after 5 years, 50 (15%) were respiratory disabled and 44 (13%) were still bacteriology positive. Twenty-four (7%) patients were lost during follow-up. Taking into account the high costs involved in treating MDR-TB patients and the scarce resources available in developing countries, more emphasis should be placed on direct observed therapy to cure newly diagnosed infectious drug sensitive tuberculosis patients, thus preventing MDR-TB rather than treating it.
Description
Keywords
ethambutol, ethionamide, isoniazid, pyrazinamide, rifampicin, streptomycin, article, controlled study, drug cost, drug efficacy, human, lung tuberculosis, major clinical study, morbidity, mortality, mycobacterium tuberculosis, south africa, treatment outcome, Adolescent, Adult, Aged, Antitubercular Agents, Female, Humans, Isoniazid, Male, Middle Aged, Mycobacterium tuberculosis, Outcome Assessment (Health Care), Pyrazinamide, Questionnaires, Retrospective Studies, Rifampin, South Africa, Time Factors, Tuberculosis, Multidrug-Resistant, Mycobacterium, Mycobacterium tuberculosis
Citation
Tropical Medicine and International Health
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