Academic Journal
Reduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwanda
| العنوان: | Reduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwanda |
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| المؤلفون: | Ngabonziza, J.-C.S., Habimana, Y.M., Decroo, T., Migambi, P., Dushime, A., Mazarati, J.B., Rigouts, L., Affolabi, D., Ivan, E., Meehan, Conor J., Van Deun, A., Fissette, K., Habiyambere, I., Nyaruhirira, A.U., Turate, I., Semahore, J.M., Ndjeka, N., Muvunyi, C.M., Condo, J.U., Gasana, M., Hasker, E., Torrea, G., de Jong, B.C. |
| Publication Status: | Published version |
| سنة النشر: | 2020 |
| المجموعة: | Bradford Scholars |
| Original Material: | Ngabonziza JS, Habimana YM, Decroo T et al (2020) Reduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwanda. International Journal Of Tuberculosis And Lung Disease. 24(3): 329-339. |
| مصطلحات موضوعية: | MDR-TB, MDR-TB programmatic management, MDR-TB treatment, Rwanda, TB |
| الوصف: | Yes SETTING: In 2005, in response to the increasing prevalence of rifampicin-resistant tuberculosis (RR-TB) and poor treatment outcomes, Rwanda initiated the programmatic management of RR-TB, including expanded access to systematic rifampicin drug susceptibility testing (DST) and standardised treatment.OBJECTIVE: To describe trends in diagnostic and treatment delays and estimate their effect on RR-TB mortality.DESIGN: Retrospective analysis of individual-level data including 748 (85.4%) of 876 patients diagnosed with RR-TB notified to the World Health Organization between 1 July 2005 and 31 December 2016 in Rwanda. Logistic regression was used to estimate the effect of diagnostic and therapeutic delays on RR-TB mortality.RESULTS: Between 2006 and 2016, the median diagnostic delay significantly decreased from 88 days to 1 day, and the therapeutic delay from 76 days to 3 days. Simultaneously, RR-TB mortality significantly decreased from 30.8% in 2006 to 6.9% in 2016. Total delay in starting multidrug-resistant TB (MDR-TB) treatment of more than 100 days was associated with more than two-fold higher odds for dying. When delays were long, empirical RR-TB treatment initiation was associated with a lower mortality.CONCLUSION: The reduction of diagnostic and treatment delays reduced RR-TB mortality. We anticipate that universal testing for RR-TB, short diagnostic and therapeutic delays and effective standardised MDR-TB treatment will further decrease RR-TB mortality in Rwanda. |
| Original Identifier: | oai:bradscholars.brad.ac.uk:10454/17785 |
| نوع الوثيقة: | Article |
| اللغة: | English |
| DOI: | 10.5588/ijtld.19.0298 |
| الاتاحة: | http://hdl.handle.net/10454/17785 |
| Rights: | (c) 2020 The Authors. This is an Open Access article distributed under the Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/) CC-BY |
| رقم الانضمام: | edsndl.BRADFORD.oai.bradscholars.brad.ac.uk.10454.17785 |
| قاعدة البيانات: | Networked Digital Library of Theses & Dissertations |
| DOI: | 10.5588/ijtld.19.0298 |
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