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

Timire, C., Sandy, C., Kumar, A. M., Ngwenya, M., Murwira, B., Takarinda, K. C. and Harries, A. D.

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.

April 12, 2019
Year of publication
2019
Resource types
Journal and research articles
Countries
Tags
rifampicin-resistant tuberculosis (RR-TB), drug susceptibility testing (DST), Hain technology, pulmonary tuberculosis, drug resistance

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