DOI

  • J-C S. Ngabonziza
  • Y. M. Habimana
  • P. Migambi
  • A. Dushime
  • J. B. Mazarati
  • D. Affolabi
  • E. Ivan
  • Habiyambere
  • A. U. Nyaruhirira
  • Innocent Turate
  • J. M. Semahore
  • N. Ndjeka
  • C. M. Muvunyi
  • J. U. Condo
  • M. Gasana

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 suscep-tibility 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 diag-nostic delay significantly decreased from 88 days to 1 day, and the therapeutic delay from 76 days to 3 days. Simultaneously, RR-TB mortality significantly de-creased 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 treat-ment 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.

Originele taal-2Engels
TijdschriftInternational Journal of Tuberculosis and Lung Disease
Volume24
Nummer van het tijdschrift3
Pagina's (van-tot)329-339
Aantal pagina's12
ISSN1027-3719
DOI's
StatusGepubliceerd - 2020

ID: 12685517