Time to Drug-Resistant Tuberculosis Treatment in a Prospective South African Cohort

Brittney J. van de Water; Janet Prvu Bettger; Susan Silva; Janice Humphreys; Coleen K. Cunningham; Jason E. Farley

doi:10.1177/2333794X17744140

Time to Drug-Resistant Tuberculosis Treatment in a Prospective South African Cohort

Brittney J. van de Water, Janet Prvu Bettger, Susan Silva, Janice Humphreys, Coleen K. Cunningham, Jason E. Farley

School of Nursing

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

This study examined time to treatment initiation by age among a prospective cohort with drug-resistant tuberculosis (DR-TB). Participants aged 13 years or older nested within a cluster-randomized trial in 2 South African provinces were evaluated. Outcomes were treatment initiation within 5 days of DR-TB diagnosis (National Tuberculosis Program guidelines) and days from diagnosis to treatment. A total of 521 participants met inclusion criteria. Eighty-two patients (16%) met national guidelines; median time to treatment was 11 days (range = 0-180). No patient (age, sex, prior TB history, HIV status) or health system characteristics (geographic urban/rural location, province) were associated with treatment initiation per guidelines except geographic location (t = 3.64, degrees of freedom = 1, P =.0003). One in 6 individuals with DR-TB received treatment per guidelines, and average time to treatment was 11 days. Strategies are needed to decrease treatment delays and meet the recommended guidelines for treatment for patients of all ages.

Original language	English (US)
Journal	Global Pediatric Health
Volume	4
DOIs	https://doi.org/10.1177/2333794X17744140
State	Published - 2017

Keywords

adolescent medicine
drug-resistance
infectious diseases
treatment
tuberculosis

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Pediatrics

Access to Document

10.1177/2333794X17744140

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title = "Time to Drug-Resistant Tuberculosis Treatment in a Prospective South African Cohort",

abstract = "This study examined time to treatment initiation by age among a prospective cohort with drug-resistant tuberculosis (DR-TB). Participants aged 13 years or older nested within a cluster-randomized trial in 2 South African provinces were evaluated. Outcomes were treatment initiation within 5 days of DR-TB diagnosis (National Tuberculosis Program guidelines) and days from diagnosis to treatment. A total of 521 participants met inclusion criteria. Eighty-two patients (16%) met national guidelines; median time to treatment was 11 days (range = 0-180). No patient (age, sex, prior TB history, HIV status) or health system characteristics (geographic urban/rural location, province) were associated with treatment initiation per guidelines except geographic location (t = 3.64, degrees of freedom = 1, P =.0003). One in 6 individuals with DR-TB received treatment per guidelines, and average time to treatment was 11 days. Strategies are needed to decrease treatment delays and meet the recommended guidelines for treatment for patients of all ages.",

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author = "{van de Water}, {Brittney J.} and {Prvu Bettger}, Janet and Susan Silva and Janice Humphreys and Cunningham, {Coleen K.} and Farley, {Jason E.}",

note = "Funding Information: We would like to acknowledge all the participants, sites, and Johns Hopkins students and study staff. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The parent study was funded by the National Institute of Allergy and Infectious Disease (R01 AI104488-01A1; Farley, PI). BJvdW was supported by the Duke University Global Health Institute Doctoral Scholars funding, Sigma Theta Tau International Honor Society of Nursing Small Grants award, Duke University Graduate School, and the Robert Wood Johnson Foundation, Future of Nursing Scholars program. CKC is supported by the Duke University Center for AIDS Research, a National Institute of Health funded program (CFAR Grant: 5P30 AI064518). Publisher Copyright: {\textcopyright} The Author(s) 2017.",

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journal = "Global Pediatric Health",

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AU - Cunningham, Coleen K.

AU - Farley, Jason E.

N1 - Funding Information: We would like to acknowledge all the participants, sites, and Johns Hopkins students and study staff. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The parent study was funded by the National Institute of Allergy and Infectious Disease (R01 AI104488-01A1; Farley, PI). BJvdW was supported by the Duke University Global Health Institute Doctoral Scholars funding, Sigma Theta Tau International Honor Society of Nursing Small Grants award, Duke University Graduate School, and the Robert Wood Johnson Foundation, Future of Nursing Scholars program. CKC is supported by the Duke University Center for AIDS Research, a National Institute of Health funded program (CFAR Grant: 5P30 AI064518). Publisher Copyright: © The Author(s) 2017.

PY - 2017

Y1 - 2017

N2 - This study examined time to treatment initiation by age among a prospective cohort with drug-resistant tuberculosis (DR-TB). Participants aged 13 years or older nested within a cluster-randomized trial in 2 South African provinces were evaluated. Outcomes were treatment initiation within 5 days of DR-TB diagnosis (National Tuberculosis Program guidelines) and days from diagnosis to treatment. A total of 521 participants met inclusion criteria. Eighty-two patients (16%) met national guidelines; median time to treatment was 11 days (range = 0-180). No patient (age, sex, prior TB history, HIV status) or health system characteristics (geographic urban/rural location, province) were associated with treatment initiation per guidelines except geographic location (t = 3.64, degrees of freedom = 1, P =.0003). One in 6 individuals with DR-TB received treatment per guidelines, and average time to treatment was 11 days. Strategies are needed to decrease treatment delays and meet the recommended guidelines for treatment for patients of all ages.

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Time to Drug-Resistant Tuberculosis Treatment in a Prospective South African Cohort

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