The 5-year outcome of multidrug resistant tuberculosis patients in the Cape Province of South Africa

Trop Med Int Health. 1996 Oct;1(5):718-22. doi: 10.1111/j.1365-3156.1996.tb00100.x.

Abstract

Little is known about the outcome of multidrug resistant (MDR) tuberculosis (TB) in developing countries. In this study, 443 patients with MDR-TB, defined as resistance to two or more antituberculosis drugs, were identified over the 2-year period 1987 and 1988 in the Cape Province of South Africa. The 5-year outcome of the 343 (77%) patients that could be traced by questionnaire was evaluated retrospectively during 1992 and 1993. Of these, 240 (70%) were resistant to both isoniazid (H) and rifampicin (R) with or without resistance to other first-line antituberculosis drugs and 103 (30%) were resistant to H or R and/or other antituberculosis drugs. Mortality was 116 (48%) and 28 (27%) in these groups respectively with a significantly greater risk of death in the first group. Only 114 (33%) of all the MDR-TB patients were cured after 5 years, 50 (15%) were respiratory disabled and 44 (13%) were still bacteriology positive. Twenty-four (7%) patients were lost during follow-up. Taking into account the high costs involved in treating MDR-TB patients and the scarce resources available in developing countries, more emphasis should be placed on direct observed therapy to cure newly diagnosed infectious drug sensitive tuberculosis patients, thus preventing MDR-TB rather than treating it.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / therapeutic use
  • Female
  • Humans
  • Isoniazid / therapeutic use
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification
  • Outcome Assessment, Health Care
  • Pyrazinamide / therapeutic use
  • Retrospective Studies
  • Rifampin / therapeutic use
  • South Africa / epidemiology
  • Surveys and Questionnaires
  • Time Factors
  • Tuberculosis, Multidrug-Resistant / epidemiology*
  • Tuberculosis, Multidrug-Resistant / mortality

Substances

  • Antitubercular Agents
  • Pyrazinamide
  • Isoniazid
  • Rifampin