Impact of Xpert MTB/RIF assay on multidrug-resistant tuberculosis treatment outcomes in a health district in South Africa
| dc.contributor.author | Mahwire, T. C. | en_ZA |
| dc.contributor.author | Zunza, M. | en_ZA |
| dc.contributor.author | Marukutira, T. C. | en_ZA |
| dc.contributor.author | Naidoo, P. | en_ZA |
| dc.date.accessioned | 2022-01-14T13:57:39Z | |
| dc.date.available | 2022-01-14T13:57:39Z | |
| dc.date.issued | 2019-04 | |
| dc.description | CITATION: Mahwire, T. C., et al. 2019. Impact of Xpert MTB/RIF assay on multidrug-resistant tuberculosis treatment outcomes in a health district in South Africa. South African Medical Journal, 109(4):259-263, doi:10.7196/SAMJ.2019.v109i4.13180. | |
| dc.description | The original publication is available at http://www.samj.org.za | |
| dc.description.abstract | Background. Xpert MTB/RIF assay rapidly diagnoses rifampicin resistance, enabling early initiation of second-line tuberculosis (TB) treatment. However, the impact of an earlier multidrug-resistant TB (MDR-TB) diagnosis on treatment outcomes is unknown. Objectives. To compare MDR-TB treatment outcomes in cases diagnosed with smear/culture and Xpert. Methods. This was a retrospective cohort study with cohorts defined by the diagnostic assay used in presumptive TB cases. Data were extracted from a drug-resistant (DR)-TB register including cases from January 2012 to June 2014. Treatment outcomes were assessed at recorded endpoints or after 2 years for those completing treatment. Results. A total of 718 cases were enrolled into the study. Cure rates were 43.4% (n=158) for the smear/culture cohort and 33.5% (n=118) for the Xpert cohort (p<0.01). Xpert diagnosis (adjusted risk ratio (aRR) 0.65; p=0.02) and male gender (aRR 0.66; p=0.04) were associated with cure outcome. Xpert diagnosis increased time to sputum culture conversion from 4 to 5 months (log-rank test p=0.01). Time to treatment initiation was not associated with treatment success in logistic regression analysis. Conclusions. Despite rapid treatment initiation, MDR-TB treatment outcomes were poorer in patients diagnosed with Xpert MTB/RIF assay than in the smear/culture cohort, and they were also poorer in men than in women. Additional studies are required to assess possible factors influencing DR-TB outcomes. | en_ZA |
| dc.description.uri | http://www.samj.org.za/index.php/samj/article/view/12571 | |
| dc.description.version | Publisher's version | |
| dc.format.extent | 5 pages : illustrations | |
| dc.identifier.citation | Mahwire, T. C., et al. 2019. Impact of Xpert MTB/RIF assay on multidrug-resistant tuberculosis treatment outcomes in a health district in South Africa. South African Medical Journal, 109(4):259-263, doi:10.7196/SAMJ.2019.v109i4.13180 | |
| dc.identifier.issn | 2078-5135 (online) | |
| dc.identifier.issn | 0256-9574 (print) | |
| dc.identifier.other | doi:10.7196/SAMJ.2019.v109i4.13180 | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/124086 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Health & Medical Publishing Group | |
| dc.rights.holder | Authors retain copyright | |
| dc.subject | Multidrug-resistant tuberculosis -- Patients -- South Africa | en_ZA |
| dc.subject | Tuberculosis -- Diagnosis -- South Africa | en_ZA |
| dc.subject | Tuberculosis -- Treatment | en_ZA |
| dc.title | Impact of Xpert MTB/RIF assay on multidrug-resistant tuberculosis treatment outcomes in a health district in South Africa | en_ZA |
| dc.type | Article | en_ZA |