Tropical medicine & international health : TM & IH · 2010
Extensively drug-resistant tuberculosis (XDR-TB) among health care workers in South Africa.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Jarand Julie, Shean Karen, O'Donnell Max, Loveday Marian, Kvasnovsky Charlotte, Van der Walt Martie, Adams Shahieda, Willcox Paul, O'Grady Justin, Zumla Alimuddin, Dheda Keertan
Аннотация
SUMMARY OBJECTIVE: To determine the clinical profile and outcomes of health care workers (HCWs) with extensively drug resistant tuberculosis (XDR-TB) in the Eastern and Western Cape Provinces of South Africa.
METHOD: Retrospective case record review of 334 patients with XDR-TB reported during the period 1996-2008 from Western and Eastern Cape Province, Cape Town, South Africa. Case records of HCWs with XDR-TB were analysed for clinical and microbiological features, and treatment outcomes.
RESULTS: From 334 case records of patients with XDR-TB, 10 HCWs were identified. Eight of ten were HIV-uninfected, and four of 10 had died of XDR-TB despite treatment. All 10 HCWs had received an average of 2.4 courses of TB treatment before being diagnosed as XDR-TB.
CONCLUSIONS: In the Eastern and Western Cape provinces of South Africa XDR-TB affects HCWs, is diagnosed rather late, does not appear to be related to HIV status and carries a high mortality. There is an urgent need for the South African government to implement WHO infection control recommendations and make available rapid drug susceptibility testing for HCWs with suspected multidrug-resistant (MDR)/XDR-TB. Further studies to establish the actual risk and sources of infection (nosocomial or community) are required.
METHOD: Retrospective case record review of 334 patients with XDR-TB reported during the period 1996-2008 from Western and Eastern Cape Province, Cape Town, South Africa. Case records of HCWs with XDR-TB were analysed for clinical and microbiological features, and treatment outcomes.
RESULTS: From 334 case records of patients with XDR-TB, 10 HCWs were identified. Eight of ten were HIV-uninfected, and four of 10 had died of XDR-TB despite treatment. All 10 HCWs had received an average of 2.4 courses of TB treatment before being diagnosed as XDR-TB.
CONCLUSIONS: In the Eastern and Western Cape provinces of South Africa XDR-TB affects HCWs, is diagnosed rather late, does not appear to be related to HIV status and carries a high mortality. There is an urgent need for the South African government to implement WHO infection control recommendations and make available rapid drug susceptibility testing for HCWs with suspected multidrug-resistant (MDR)/XDR-TB. Further studies to establish the actual risk and sources of infection (nosocomial or community) are required.