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Ngabonziza, S., Habimana, Y.M., Decroo, T., Migambi, P., Dushime, A., Mazarati, J.B., Rigouts, L., Affolabi, D., Ivan, E., Meehan, C.J. 
ORCID: 0000-0003-0724-8343, 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. and de Jong, B.C.,
2020.
Reduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwanda.
International Journal of Tuberculosis and Lung Disease, 24 (3), pp. 329-339.
ISSN 1027-3719
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Abstract
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.
| Item Type: | Journal article | ||||||
|---|---|---|---|---|---|---|---|
| Publication Title: | International Journal of Tuberculosis and Lung Disease | ||||||
| Creators: | Ngabonziza, S., Habimana, Y.M., Decroo, T., Migambi, P., Dushime, A., Mazarati, J.B., Rigouts, L., Affolabi, D., Ivan, E., Meehan, C.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. and de Jong, B.C. | ||||||
| Publisher: | International Union Against Tuberculosis and Lung Disease | ||||||
| Date: | 1 March 2020 | ||||||
| Volume: | 24 | ||||||
| Number: | 3 | ||||||
| ISSN: | 1027-3719 | ||||||
| Identifiers: |
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| Rights: | © 2020 The Union. This work is licensed under a Creative Commons Attribution 4.0 International License. | ||||||
| Divisions: | Schools > School of Science and Technology | ||||||
| Record created by: | Jonathan Gallacher | ||||||
| Date Added: | 14 Dec 2022 09:27 | ||||||
| Last Modified: | 14 Dec 2022 09:27 | ||||||
| URI: | https://irep.ntu.ac.uk/id/eprint/47658 |
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