MDR-TB Treatment Outcomes in South Africa
Author Information
Author(s): Farley Jason E., Ram Malathi, Pan William, Waldman Stacie, Cassell Gail H., Chaisson Richard E., Weyer Karin, Lancaster Joey, Van der Walt Martie
Primary Institution: Johns Hopkins University School of Nursing
Hypothesis
What are the treatment outcomes of multi-drug resistant tuberculosis (MDR-TB) among patients with high HIV prevalence in South Africa?
Conclusion
Patients with HIV infection and low weight had higher hazards of death, and overall treatment outcomes were poor.
Supporting Evidence
- Overall treatment success rate was 46%, with 21% cured and 25% completing treatment.
- Patients with HIV were less likely to have a successful treatment outcome than HIV negative patients (40% vs. 49.6%).
- Patients with HIV had a higher hazard of death (HR: 2.33, P<0.0001).
- Low baseline weight was associated with a higher hazard of death.
Takeaway
This study looked at how well people with drug-resistant tuberculosis were treated in South Africa, especially those with HIV. It found that many didn't get better and some died.
Methodology
The study assessed treatment outcomes in a prospective cohort of patients with MDR-TB from eight provincial programs providing second line drugs, using WHO definitions.
Potential Biases
The study may underrepresent the true prevalence of HIV as a large proportion of the original cohort were not tested.
Limitations
Data on HIV status and CD4 counts were not uniformly available, and adherence to treatment was poorly documented.
Participant Demographics
The cohort included 757 patients, with 38% having HIV infection, and a mean age of 36.5 years.
Statistical Information
P-Value
p<0.0001
Confidence Interval
95% CI 1.55–5.29
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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