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Journal Article
|Research

Implementing a substance-use screening and intervention program for people living with rifampicin-resistant tuberculosis: pragmatic experience from Khayelitsha, South Africa

Reuter A, Beko B, Memani B, Furin J, Daniels J, Rodriguez E, Reuter H, Weich L, Isaakidis P, von der Heyden E, Kock Y, Mohr-Holland E
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Implementing a substance-use screening and intervention program for people living with rifampicin-resistant tuberculosis: pragmatic experience from Khayelitsha, South Africa | Journal Article / Research | MSF Science Portal
Abstract
Substance use (SU) is associated with poor rifampicin-resistant tuberculosis (RR-TB) treatment outcomes. In 2017, a SBIRT (SU screening-brief intervention-referral to treatment) was integrated into routine RR-TB care in Khayelitsha, South Africa. This was a retrospective study of persons with RR-TB who were screened for SU between 1 July 2018 and 30 September 2020 using the ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). Here we describe outcomes from this program. Persons scoring moderate/high risk received a brief intervention and referral to treatment. Overall, 333 persons were initiated on RR-TB treatment; 38% (n = 128) were screened for SU. Of those, 88% (n = 113/128) reported SU; 65% (n = 83/128) had moderate/high risk SU. Eighty percent (n = 103/128) reported alcohol use, of whom 52% (n = 54/103) reported moderate/high risk alcohol use. Seventy-seven persons were screened for SU within ≤2 months of RR-TB treatment initiation, of whom 69%, 12%, and 12% had outcomes of treatment success, loss to follow-up and death, respectively. Outcomes did not differ between persons with no/low risk and moderate/high risk SU or based on the receipt of naltrexone (p > 0.05). SU was common among persons with RR-TB; there is a need for interventions to address this co-morbidity as part of "person-centered care". Integrated, holistic care is needed at the community level to address unique challenges of persons with RR-TB and SU.

Countries

South Africa

Subject Area

antibiotic resistancetuberculosisantimicrobial resistancefilovirussubstance use disorders

Languages

English
DOI
10.3390/tropicalmed7020021
Published Date
31 Jan 2022
PubMed ID
35202216
Journal
Tropical Medicine and Infectious Disease
Volume | Issue | Pages
Volume 7, Issue 2, Pages 21
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