Access to second-line drug susceptibility testing results among patients with Rifampicin resistant tuberculosis after introduction of the Hain((R)) Line Probe Assay in Southern provinces, Zimbabwe
OBJECTIVES: To determine the proportion of rifampicin-resistant tuberculosis (RR-TB) patients who accessed second-line drug susceptibility testing (SL-DST) results following introduction of the Hain technology in southern provinces, Zimbabwe.
DESIGN: Cohort study using secondary data.
RESULTS: Xpert MTB/RIF results were used to identify 133 RR-TB patients for this study. Their mean age (SD) was 37.9 (11.1) years, 83(62%) were males and 106 (80%) were HIV-infected. There were 6 (5%) participants who had pre-treatment attrition. Of the 133 pulmonary TB (PTB) patients, 117(80%) had additional sputum specimens collected; 96(72%) specimens reached the National TB Reference Laboratory (NTBRL); 95(71%) were processed; 68(51%) had SL-DST results. Only 53(40%) SL-DST results reached the peripheral facilities. Median time from specimen collection to reception at the NTBRL to SL-DSTs was 40 days, interquartile range (IQR:28-67). Median time from presumptive diagnosis of RR-TB by health care worker to SL-DST results was 50days (IQR:39-80), and increased to 79days (IQR:39-101) in facilities >250km from the NTBRL. The proportion with any fluoroquinolone resistance was 9(13.2%).
CONCLUSION: Although RR-TB patients with PTB were initiated timely on treatment, access to SL-DSTs by facilities needs improvement. Health inequities exist as remote areas are less likely to get SL-DST results in time.