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Factors affecting treatment outcomes in drug-resistant tuberculosis cases in the Northern Cape,South Africa
Authors:E Elliott  H R Draper  P Baitsiwe  M M Claassens
Institution:1. InterSystems, Sandton, South Africa ;2. Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa ;3. TB Programme, Northern Cape Province, Kimberley, South Africa
Abstract:The Northern Cape Province has low cure rates (21%) for multidrug-resistant tuberculosis (TB). We audited the programme to identify factors affecting treatment outcomes. Cases admitted to two drug-resistant TB units from 2007 to 2009 had data extracted from clinical folders. Unfavourable treatment outcomes were found in 58% of the 272 cases. A multivariable regression analysis found that male sex was associated with unfavourable outcome (P = 0.009). Weight at diagnosis (P < 0.001) and oral drug adherence (P < 0.001) were also associated with an unfavourable outcome; however, injectable drug adherence was not (P = 0.395). Positive baseline smear and human immunodeficiency virus positive status were not associated with unfavourable outcome. Shorter, more patient-friendly regimens may go a long way to improving adherence and outcomes.
Keywords:treatment adherence  weight  HIV  smear-status  audit  unfavourable treatment outcomes
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