A retrospective analysis of drug-resistant tuberculosis trends and causal factors in the period between 2016 and 2020 in the Sarah Baartman District of the Eastern Cape province, South Africa.
Loading...
Date
2025-03-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of Fort Hare
Abstract
Introduction
Resistance to anti-tuberculosis (TB) medication is a challenge that TB control practitioners have seen increasing in recent years. Drug-resistant (DR) TB can be caused by many factors, among them non-adherence to medication, substandard medication, inadequate patient care and airborne transmission. The prevalence of DRTB was high, and there was a significant spike in the number of Rifampicin-resistant cases in the Sarah Baartman district. This study aimed to conduct a retrospective analysis of trends and causal factors to Drug-Resistant Tuberculosis in the Sarah Baartman district from 2016 to 2020 using EDR-web, the Drug-resistant Tuberculosis Register.
Methods
A retrospective, descriptive and quantitative study design was used. Data were collected from files of 100 TB adult patients’ records who had been treated and admitted at the Margery Parkes TB Hospital in Graaf-Reinet. A data extraction tool was used to collect data from the EDR-web register, which was later captured onto a Microsoft Excel® spreadsheet for further analysis.
Results
Almost two-thirds of the patients in the study were males (60%) and had an average age of 40.8 years. Of the 100 participants, 54% were infected with HIV, and they had a mean CD4 count of 226 with a 95% confidence interval of (161.8 290.2). Sixty-six percent had previously been treated for TB, and 59.1% had been cured. In relation to the current DR-TB diagnosis, 49% had RR-TB, 46% had MDR-TB, and 5% had preXDR. The time taken to initiate patients on treatment was around 15 days, and the treatment duration was an average of 10.8 months. The treatment used was consistent with the WHO guidelines. Most of the patients were on Pyrazinamide PZA (100%), High dose Isoniazid at 89%, Bedaquiline at 82%, Ethambutol at 79%, Clofazimine at 78%, and Levofloxacin at 74%. Thirteen per cent of the participants reported side effects due to the treatment. Concerning treatment outcome, a 60% treatment success rate was achieved and 19% of the participants died.
Conclusion
The prevalence of DR-TB was found to be high, and an alarming spike in the number of Rifampicin-resistant cases was observed. DR-TB and TB, in general, are more common in males and affect the economically active age group. People living with HIV are at a higher risk of contracting DR-TB because of their weakened immune systems. Treatment compliance will positively affect CD4 count and treatment outcomes. There is a high risk of developing DR-TB or Pre-XDR-TB, without having been previously exposed to TB or TB treatment. RR-TB is emerging fast and is more prevalent than MDR-TB. DR-TB has a high mortality rate when treatment is delayed. Community mobilisation and patient education aimed at improving health-seeking behaviour and basic household infection control mechanisms would be recommended as interventions to curb the spread of DR-TB.
Description
Master's dissertation
Keywords
Tuberculosis, Cell adhesion, South Africa
Citation
Petrus, S.J. (2025). A retrospective analysis of drug-resistant tuberculosis trends and causal factors in the period between 2016 and 2020 in the Sarah Baartman District of the Eastern Cape province, South Africa. Master's dissertation. University of Fort Hare.