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Volume 27, Number 3—March 2021
Synopsis

Decentralized Care for Rifampin-Resistant Tuberculosis, Western Cape, South Africa

Sarah V. LeavittComments to Author , Karen R. Jacobson, Elizabeth J. Ragan, Jacob Bor, Jennifer Hughes, Tara C. Bouton, Tania Dolby, Robin M. Warren, and Helen E. Jenkins
Author affiliations: Boston University, Boston, Massachusetts, USA (S.V. Leavitt, K.R. Jacobson, E.J. Ragan, J. Bor, T.C. Bouton, H.E. Jenkins); Boston Medical Center, Boston (K.R. Jacobson, E.J. Ragan, T.C. Bouton); University of the Witwatersrand, Johannesburg, South Africa (J. Bor); Stellenbosch University, Stellenbosch, South Africa (J. Hughes, R.M. Warren); Brown University, Providence, Rhode Island, USA (T.C. Bouton); Green Point Tuberculosis Laboratory, Cape Town, South Africa (T. Dolby); South African Medical Research Council Centre for Tuberculosis Research, Cape Town (R.M. Warren); Department of Science and Technology–National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, Cape Town (R.M. Warren)

Main Article

Table 3

Linear temporal trends in magnitude and duration of movement for adult patients with RR TB, Western Cape, South Africa, 2012–2014*

Description Overall, n = 2,878
Cape Town, n = 1,878
Outside Cape Town, n = 1,000
Interaction
p value†
Slope 
(95% CI) p value Slope 
(95% CI) p value Slope 
(95% CI) p value
Hospitalization in TB hospital, no. (%) 
No. patients with >1 sample from a specialized TB hospital in the first year after RR TB diagnosis
−0.4 
(−1.2 to 0.5)
0.33

−1.0 
(−1.7 to −0.2)
0.02

1.1 
(−0.9 to 3.1)
0.23
0.03
Moved to care outside TB hospital, no. (%)
No. patients with a sample from a TB hospital who had a subsequent sample from a non-TB hospital <3 mo after the most recent sample in the TB hospital
0.2 
(−0.9 to 1.3)
0.69

0.1 
(−1.3 to 1.6)
0.84

−0.01 
(−1.8 to 1.8)
0.99
0.89
Median length of TB hospital stay, d (IQR)
Median hospitalization period of patients who moved to care outside of a TB hospital in the first year after RR TB diagnosis
−1.5 
(−5.7 to 2.6)
0.42

−3.6 (−8.7 to 1.5)
0.14

−0.28 
(−4.3 to 3.7)
0.87
0.24
Any movement, no. (%)
No. patients who had samples from >2 different facilities in first year after RR TB diagnosis
−0.5 
(−1.2 to 0.3)
0.19

−0.9 
(−1.7 to −0.06)
0.04

0.5 
(−1.2 to 2.3)
0.50
0.10
Median no. of visits (IQR)
No. unique days with >1 laboratory sample in the first year after RR TB diagnosis
0.04 
(−0.01 to 0.1)
0.12

0.0 
(−0.2 to 0.2)
>0.99

0.1 
(−0.01 to 0.2)
0.06
0.22
Median total distance, km (IQR)
Total Euclidian distance between all facilities visited by each patient in the first year after RR TB diagnosis
−0.1 
(−0.4 to 0.2)
0.43

−0.3 
(−0.5 to −0.01)
0.04

4.7 
(−1.3 to 10.6)
0.10
0.07
Median distance between consecutive visits, km (IQR)
Median distance between facilities visited consecutively by each patient in the first year after RR TB diagnosis −0.06 
(−0.2 to 0.04) 0.21 −0.18 
(−0.4 to −0.02) 0.07 2.5 
(−0.5 to 5.6) 0.09 0.05

*Patients without second-line drug resistance who attended >2 visits. Estimates are change per quarter (i.e., 3 mos). RR, rifampin-resistant; TB, tuberculosis.
†p value of interaction term between quarter of diagnosis and location.

Main Article

Page created: January 29, 2021
Page updated: February 21, 2021
Page reviewed: February 21, 2021
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