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Volume 27, Number 3—March 2021
Synopsis

Decentralized Care for Rifampin-Resistant Tuberculosis, Western Cape, South Africa

Sarah V. LeavittComments to Author , Karen R. Jacobson, Elizabeth J. Ragan, Jacob Bor, Jennifer Hughes, Tara C. Bouton, Tania Dolby, Robin M. Warren, and Helen E. Jenkins
Author affiliations: Boston University, Boston, Massachusetts, USA (S.V. Leavitt, K.R. Jacobson, E.J. Ragan, J. Bor, T.C. Bouton, H.E. Jenkins); Boston Medical Center, Boston (K.R. Jacobson, E.J. Ragan, T.C. Bouton); University of the Witwatersrand, Johannesburg, South Africa (J. Bor); Stellenbosch University, Stellenbosch, South Africa (J. Hughes, R.M. Warren); Brown University, Providence, Rhode Island, USA (T.C. Bouton); Green Point Tuberculosis Laboratory, Cape Town, South Africa (T. Dolby); South African Medical Research Council Centre for Tuberculosis Research, Cape Town (R.M. Warren); Department of Science and Technology–National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, Cape Town (R.M. Warren)

Main Article

Table 1

Characteristics of patients with RR TB, Western Cape, South Africa, 2012–2014*

Characteristic† Overall, n = 2,878 Cape Town, n = 1,878 Outside Cape Town n = 1,000 p value‡
Sex§ 0.32
F 1,245 (43.4) 825 (44.1) 420 (42.0)
M
1,626 (56.6)
1,047 (55.9)
579 (58.0)

Age group, y¶ <0.01
15–34 1,420 (50.1) 978 (53.0) 442 (44.9)
35–54 1,232 (43.5) 761 (41.2) 471 (47.8)
>55
180 (6.4)
108 (5.8)
72 (7.3)

Type of TB 0.72
Pulmonary only 2,685 (93.3) 1,747 (93.0) 938 (93.8)
Extrapulmonary only 70 (2.4) 47 (2.5) 23 (2.3)
Both
123 (4.3)
84 (4.5)
39 (3.9)

Results of closest smear within 30 d of first RR TB–positive sample 0.93
Negative 1,396 (48.5) 913 (48.6) 483 (48.3)
Scanty positive 310 (10.8) 202 (10.8) 108 (10.8)
Positive + 262 (9.1) 178 (9.5) 84 (8.4)
Positive ++ 181 (6.3) 118 (6.3) 63 (6.3)
Positive +++ 499 (17.3) 321 (17.1) 178 (17.8)
Unknown
230 (8.0)
146 (7.8)
84 (8.4)

Setting of first RR TB–positive result <0.01
TB hospital 103 (3.6) 43 (2.3) 60 (6.0)
Clinic 2,361 (82.0) 1,554 (82.7) 807 (80.7)
Non-TB hospital
414 (14.4)
281 (15.0)
133 (13.3)

Median time in care** in first year after RR TB diagnosis, mos (IQR) 11 (5–12) 11 (5–12) 11 (6–12) <0.01#
Median number of visits†† in the first year after RR TB diagnosis, (IQR) 9 (5–12) 8 (4–12) 10 (5–12) <0.01#

*Patients without second-line drug resistance who attended >2 visits. RR, rifampin-resistant; TB, tuberculosis.
†Data are no. (%), except where otherwise indicated.
‡p values determined by χ2 test of patients in Cape Town versus outside Cape Town.
§A total of 7 patients were missing data on sex: 6 from Cape Town and 1 from outside of Cape Town.
¶A total of 46 patients were missing data on age: 31 from Cape Town and 15 from outside of Cape Town.
#p values determined by Wilcoxon rank-sum test of patients in Cape Town versus outside Cape Town.
**Time in care is defined as the time between the first and most recent RR TB–positive sample or 1 y from the first RR TB–positive sample, whichever was earlier.
††Defined as unique days in which a patient submitted >1 sample.

Main Article

Page created: January 29, 2021
Page updated: February 21, 2021
Page reviewed: February 21, 2021
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