Managing multidrug-resistant tuberculosis in South Africa: a budget impact analysis

Epidemic spread of multidrug-resistant tuberculosis in Johannesburg, South Africa.

Numerous reports have documented isolated transmission events or clonal outbreaks of multidrug-resistant Mycobacterium tuberculosis strains, but knowledge of their epidemic spread remains limited. In this study, we evaluated drug resistance, strain diversity, and clustering rates in patients diagnosed with multidrug-resistant (MDR) tuberculosis (TB) at the National Health Laboratory Service (NH...

Programmatically Selected Multidrug-Resistant Strains Drive the Emergence of Extensively Drug-Resistant Tuberculosis in South Africa

BACKGROUND South Africa shows one of the highest global burdens of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB). Since 2002, MDR-TB in South Africa has been treated by a standardized combination therapy, which until 2010 included ofloxacin, kanamycin, ethionamide, ethambutol and pyrazinamide. Since 2010, ethambutol has been replaced by cycloserine or terizido...

Extensively drug-resistant tuberculosis in South Africa.

Keertan Dheda and colleagues (May 22, p 1798) report extremely poor treatment outcomes for patients with extensively drug-resistant (XDR) tuberculosis in South Africa and conclude that prevention of XDR tuberculosis through strengthening of tuberculosis pro grammes overall should be prioritised. Most patients diagnosed with XDR tuberculosis in this cohort (72%) had previously been diagnosed wit...

Determinants of multidrug-resistant tuberculosis in South Africa: results from a national survey.

Evaluation of a nurse practitioner-physician task-sharing model for multidrug-resistant tuberculosis in South Africa

BACKGROUND Treatment success rates for multidrug-resistant tuberculosis (MDR-TB) in South Africa remain close to 50%. Lack of access to timely, decentralized care is a contributing factor. We evaluated MDR-TB treatment outcomes from a clinical cohort with task-sharing between a clinical nurse practitioner (CNP) and a medical officer (MO). METHODS We completed a retrospective evaluation of out...