Dataset Information

The epidemiology of drug-resistant tuberculosis in Bulawayo and Matabeleland South provinces, Zimbabwe 2017

ABSTRACT: Highlights • Diagnosis of DRTB was delayed by the initial wrong and ineffective treatment that was provided to about 70% of patients, impacting negatively on treatment outcomes• Being <6 months from previous TB treatment was associated with unfavourable treatment outcomes.• Strengthening access to drug sensitivity testing at diagnosis is important in DR-TB identification and control.

Objective

To investigate determinants of drug resistance and treatment outcomes among patients with drug-resistant tuberculosis (DR-TB).

Design

This was a cross-sectional study on patients diagnosed with DR-TB in Bulawayo and Matabeleland South provinces, 2015.

Results

A total of 129 participants were identified. DR-TB patients were 3.4 times more likely to have been treated previously for sensitive TB (95% confidence interval 1.3–9.2). Approximately 88.5% of DR-TB patients were diagnosed before completing the sensitive TB course and another 82.1% developed DR-TB within 6 months of completing sensitive TB treatment. The likelihood diminished with increasing time interval, becoming less likely at >12 months post-treatment. Most DR-TB patients (87.5%) were likely to have resided outside Zimbabwe and to have fallen ill there (85.2%). Overall, hearing loss was the most prevalent (70%) medication side effect experienced. Unfavourable interim treatment outcomes were high for patients <6 months on treatment (prevalence odds ratio 2.7, 95% CI 1.2–6.1), becoming 44% less likely after 18 months (95% CI 1.2–11.4).

Conclusions

The majority of DR-TB patients were diagnosed during sensitive TB treatment, suggesting missed DR-TB diagnosis or inadequate treatment. Delays in starting effective TB regimens negatively affect treatment outcomes. Drug sensitivity testing at diagnosis, patient monitoring, and enhanced adherence counselling are recommended.

SUBMITTER: Mugauri (Dumisani) H

PROVIDER: S-EPMC9216256 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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