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Factors Contributing to the Emergence of DR TB in the Northern Cape Province and the Cost of Treatment
Current Issue
Volume 7, 2019
Issue 1 (March)
Pages: 1-10   |   Vol. 7, No. 1, March 2019   |   Follow on         
Paper in PDF Downloads: 9   Since Apr. 9, 2019 Views: 127   Since Apr. 9, 2019
Eshetu Bekele Worku, Reserach and Development Unit, Northern Cape Department of Health, Kimberley, South Africa.
Mbesi Joseph Ngundu, District Clinical Specialist Team, Northern Cape Department of Health, Kimberly, South Africa.
Globally, Tuberculosis (TB) burden is quite substantial and a big concern. In recent years, particularly Drug Resistant Tuberculosis (DR TB) has cut many lives short and become a growing threat in many developing countries. South Africa, despite government’s comprehensive TB treatment care and support, has an increasing number of new DR TB cases. This study aimed at describing factors contributing to the emergence of DR TB in the Northern Cape Province, South Africa. A cross-sectional, descriptive study design was used on purposively selected DR TB patients who were on treatment in the West End and Dr Harry Surtie Regional Hospitals between 01 October 2014 and 31 December 2015. Both quantitative and qualitative methods were used to gather information from research respondents. Logistic regression analysis was used to compare risk factors related with the emergence of DR TB cases. Out of the 156 DR TB patients, close to one-third (36%) were previous treatment defaulters, while the majority (64%) were newly infected. Average treatment costs per patient at public health facility is about R190,000 (14,179 USD). The logistic regression analysis shows that respondents’ residence (OR=0.13; PV = 0.002); client happiness to take medicine (OR = 0.29; PV = 0.021); alcohol consumption (OR = 0.15; PV= 0.036); missed treatment practices (OR = 0.59; PV=0.000); and TB disease information (OR = 0.26; PV= 0.009) are significantly contributed to default of treatment at 5% level of significance, and 95% of confidence intervals. All-inclusive approach is required to effectively tackle several risk factors for emergence of DR TB in a cost-effective ways and reduce the number of TB treatment defaulters.
Tuberculosis, Adherence, Drug Resistant Tuberculosis, Co-infection, Northern Cape
World Health Assembly. Post-2015 global TB strategy and targets (A67/62). Geneva: World Health Assembly, 2014.
World Health Organization. Global tuberculosis report 2015. Geneva: WHO, 2015.
World Health Organization. Macroeconomics and Health: Investing in health for economic development, Report of the Commission on Macroeconomics and Health. WHO, 2001.
World Bank. Poverty and Health. Accessed on 23/02/2017. [home page on the Internet]. [cited 2016 December 12]. Available from: http://www.worldbank.org/en/topic/health/brief/poverty-health
UNFPA. Health and Poverty. UNFPA State of World Population 2002.
Centers for Disease Control and Prevention. Morbidity and Mortality Report. 25 March, 2011.
Commission on the Social Determinants of Health. Closing the Gap in a Generation. World Health Organization, 2008.
Worku EB, Woldesenbet SA. Poverty and inequality–but of what-as social determinants of health in Africa? African Health Science. 2015; 15.
Africa’s Medical Media Digest. [home page on the Internet]. [cited 2015 December 12]. Available from: World TB Day – Launch of online TB Surveillance Dashboard - Medical Brief.mht. March 29th, 2017.
UNAIDS. Regional Report Getting to zero: HIV in Eastern and Southern Africa. UNAIDS. Geneva, 2013.
Shisana O. Rehel T. Simbayi C. et al. (2014). South Africa National HIV Prevalence, Incidence and Beheviour Survey, 2012. Cape Town, HSRC Press.
National Department of Health. Multi-Drug Resistant Tuberculosis. A Policy Framework on Decentralised and Deinstitutionalised Management for South Africa, NDOH. 2011.
National Department of Health. National Tuberculosis Management Guidelines. 2014. [home page on the Internet]. [cited 2016 November 17]. Available at: http://www.nicd.ac.za/assets/files/Acrobat%20Document2.pdf
Northern Cape Department of Health. Annual Performance Report of the Northern Cape Department of Health. NCDOH, 2015.
Worku E, Ngundu J, Duran C, Leyet R, Mastrapa B, et al. (2016). Report on Factors contributing to the emergence of Drug Resistance Tuberculous (DR TB) in the Northern Cape Province and the cost of treatment, 2015, Kimberley, Northern Cape Department of Health.
Houben R. Menzies A. Sumner T. et al. Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India: a combined analysis of 11 mathematical models. Lancet Glob Health 2016; published online Oct 6.
Medicines San Frontiers. Decentralised Diagnosis and Treatment of Drug-Resistant Tuberculosis in Khayelitsha, South Africa. Outcome and success of the decentralized model of care March 2015.
Suen C. Bendavid E. Goldhaber-Fiebert D. Cost-effectiveness of improvements in diagnosis and treatment accessibility for tuberculosis control in India. Int J Tuberc Lung Dis 2015; 19: 1115–24.
Padmanesan N. James W. Chandini M, and Dilip M. Risk Factors for Tuberculosis. Pulmonary Medicine, 2013.
Knight M. Gomez B. Dodd J. et al. The impact and cost-effectiveness of a four-month regimen for first-line treatment of active tuberculosis in South Africa. PLoS One 2015; 10: e0145796.
Jackson S. Sleigh C. Wang J. et al. Poverty and the economic effects of TB in rural China. Int J Tuberc Lung Dis 2006; 10: 1104–10.
Laurence V. Griffiths K. Vassall A. Costs to health services and the patient of treating tuberculosis: a systematic literature review. Pharmacoeconomics 2015; 33: 939–55.
Wang L. Zhang H. Ruan Y. et al. Tuberculosis prevalence in China, 1990–2010; a longitudinal analysis of national survey data. Lancet 2014; 383: 2057–64.
Sagbakken M. Frich J. Bjune G. Barriers and enablers in the management of tuberculosis treatment in Addis Ababa, Ethiopia: A qualitative study. BMC Public Health 2008, 8, 11.
Widjanarko B. Gompelman M. Dijkers M. et al. Factors that influence treatment adherence of tuberculosis patients living in Java, Indonesia. Patient Prefer Adherence 2009; 3: 231-8.
Lutge E. Wiysonge S. Knight E. et al. Material incentives and enablers in the management of tuberculosis. Cochrane Database Syst Rev 2012; 1: CD007952.
Bruce K. Willy S. Catherine M, et al. Tuberculosis risk factors among tuberculosis patients in Kampala, Uganda: implications for tuberculosis control, BMC Public Health. 2015; 15: 13.
Nabil T. The impact of knowledge and attitudes on adherence to tuberculosis treatment: a case-control study in a Moroccan region. The Pan African Medical Journal. 2012; 12: 52. doi: 10.11604/pamj.2012.12.52.1374.
Rehm J. Samokhvalov V, Neuman G. et al. The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review. BMC Public Health. 2009; 9 (450): 1471–2458.
Wang J. Fei Y. Shen H et al. Gender difference in knowledge of tuberculosis and associated health-care seeking behaviors: a cross-sectional study in a rural area of China. BMC Public Health. 2008; 8: 354.
Gambhir S. Kaushik M. Kaushik R. et al. Tobacco smoking-associated risk for tuberculosis: a case–control study. Int Health. 2010; 2 (3): 216–22.
Pawlowski A. Jansson M. Sköld M. et al. Tuberculosis and HIV Co-Infection. PLoS Pathog, 2012, 8 (2).
Worku E. and Wodesenbet S. Factors that Influence Teenage Antenatal Care Utilization in John Taolo Gaetsewe (JTG) District of Northern Cape Province, South Africa: Underscoring the Need for Tackling Social Determinants of Health. Int J MCH AIDS v. 5 (2); 2016.
Foster N. Vassall A. Cleary S. et al. The economic burden of TB diagnosis and treatment in South Africa. Soc Sci Med 2015; 130: 42–50.
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