TY - JOUR AU - Leavitt, Sarah AU - Jacobson, Karen AU - Ragan, Elizabeth AU - Bor, Jacob AU - Hughes, Jennifer AU - Bouton, Tara AU - Dolby, Tania AU - Warren, Robin AU - Jenkins, Helen T1 - Decentralized Care for Rifampin-Resistant Tuberculosis, Western Cape, South Africa T2 - Emerging Infectious Disease journal PY - 2021 VL - 27 IS - 3 SP - 728 SN - 1080-6059 AB - In 2011, South Africa implemented a policy to decentralize treatment for rifampin-resistant tuberculosis (TB) to reduce durations of hospitalization and enable local treatment. We assessed policy implementation in Western Cape Province, where services expanded from 6 specialized TB hospitals to 406 facilities, by analyzing National Health Laboratory Service data on TB during 2012–2015. We calculated the percentage of patients who visited a TB hospital <1 year after rifampin-resistant TB diagnosis, the median duration of their hospitalizations, and the total distance between facilities visited. We assessed temporal changes with linear regression and stratified results by location. Of 2,878 patients, 65% were from Cape Town. In Cape Town, 29% visited a TB hospital; elsewhere, 68% visited a TB hospital. We found that hospitalizations and travel distances were shorter in Cape Town than in the surrounding areas. KW - treatment KW - hospitalization KW - drug resistance KW - routinely collected data KW - health policy KW - antimicrobial resistance KW - rifampin KW - tuberculosis KW - decentralized care KW - respiratory infections KW - bacteria KW - South Africa KW - rifampin-resistant DO - 10.3201/eid2703.203204 UR - https://wwwnc.cdc.gov/eid/article/27/3/20-3204_article ER - End of Reference