Title: Community-based treatment for multidrug-resistant tuberculosis in rural KwaZulu-Natal, South Africa
Authors: Heller T, Lessells RJ, Wallrauch C, Barnighausen T, Cooke GS, Mhlongo L, Master I, Newell ML.
Journal: Int J TB Lung Dis,14:420-426 (2010)
Journal Impact Factor (I.F.): 2.557
Number of citations (Google Scholar): 27
SETTING: Hlabisa health sub-district, KwaZulu-Natal,
OBJECTIVE: To describe the establishment of a
c ommunity-based multidrug-resistant tuberculosis
(MDR-TB) treatment programme embedded in the district
TB control programme and to evaluate whether
early outcomes are comparable to those in the traditional
hospital-based model of care.
DESIGN: Cases who initiated community-based MDRTB
treatment (CM) between March and December 2008
were compared with patients who initiated MDR-TB
treatment under the traditional hospital-based model of
care (TM) between January 2001 and February 2008.
Time to initiation of treatment and time to sputum smear
and culture conversion were compared for the two groups
in Kaplan-Meier survival curves using the Mantel-Cox
RESULTS: Overall, 50 CM cases and 57 TM cases were
included; 39 of the 50 CM cases (78.0%) were human
immunodefi ciency virus positive. The median time to initiation
of treatment was 84 days for CM and 106.5 days
for TM (P = 0.002). Median time to sputum smear conversion
was shorter for CM than TM (59 vs. 92 days,
P = 0.055), as was time to sputum culture conversion
(85 vs. 119 days, P = 0.002).
CONCLUSION: Community-based treatment for MDRTB
can be implemented within the existing TB control
programme in rural South Africa and should be scaled
up where resources allow.
Citation: Heller T, Lessells RJ, Wallrauch C, Barnighausen T, Cooke GS, Mhlongo L, Master I, Newell ML. Community-based treatment for multidrug-resistant tuberculosis in rural KwaZulu-Natal, South Africa Int J TB Lung Dis,14:420-426 (2010).