Rifampicin resistant tuberculosis in Lesotho : diagnosis, treatment initiation and outcomes
Date
2019-12
Journal Title
Journal ISSN
Volume Title
Publisher
Nature Research [Commercial Publisher]
Abstract
The 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.
Description
Global Health: Epidemiology and Biostatistics
CITATION: 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/s41598-020-58690-4
The original publication is available at: http://www.nature.com/srep/index.html
CITATION: 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/s41598-020-58690-4
The original publication is available at: http://www.nature.com/srep/index.html
Keywords
Tuberculosis, rifampicin resistance, Xpert MTB/RIF, Lesotho
Citation
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/s41598-020-58690-4