Journal Article > LetterFull Text
Int J Tuberc Lung Dis. 1 October 2022; Volume 26 (Issue 10); 986-988.; DOI:10.5588/ijtld.22.0264
Tyeku N, Apolisi I, Daniels J, Beko B, Memani B, et al.
Int J Tuberc Lung Dis. 1 October 2022; Volume 26 (Issue 10); 986-988.; DOI:10.5588/ijtld.22.0264
Journal Article > ResearchFull Text
Public Health Action. 21 June 2022; Volume 12 (Issue 2); 55-57.; DOI:10.5588/pha.21.0083
Memani B, Beko B, Dumile N, Mohr-Holland E, Daniels J, et al.
Public Health Action. 21 June 2022; Volume 12 (Issue 2); 55-57.; DOI:10.5588/pha.21.0083
Patients initiated on drug-resistant TB (DR-TB) treatment in 2019 in Khayelitsha, South Africa, with a loss to follow-up outcome were evaluated to better understand reasons for loss to follow-up and to determine if any had returned to care. Of a total of 187 patients, 28 (15%) were lost to follow-up (LTFU), 24 (86%) of whom were traced: 20/24 (83%) were found when they re-presented to facilities and 8/28 (29%) were linked back to DR-TB care. People with DR-TB continue to seek care even after being LTFU; thus better coordination between different components of the healthcare system are required to re-engage with these patients. Interventions to mitigate the socio-economic challenges of people on DR-TB treatment are needed. Many people who were LTFU and symptomatic were willing to re-engage with DR-TB care, which highlights the importance of for compassionate interventions to welcome them back.
Journal Blog > Perspective
PLoS Blogs. 1 March 2022
Beko B, Furin J
PLoS Blogs. 1 March 2022
Journal Article > ResearchFull Text
Trop Med Infect Dis. 31 January 2022; Volume 7 (Issue 2); 21.; DOI: 10.3390/tropicalmed7020021
Reuter A, Beko B, Memani B, Furin J, Daniels J, et al.
Trop Med Infect Dis. 31 January 2022; Volume 7 (Issue 2); 21.; DOI: 10.3390/tropicalmed7020021
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.
Journal Article > ResearchFull Text
PLOS One. 18 May 2017; Volume 12 (Issue 5); e0178054.; DOI:10.1371/journal.pone.0178054
Mohr E, Daniels J, Beko B, Isaakidis P, Cox V, et al.
PLOS One. 18 May 2017; Volume 12 (Issue 5); e0178054.; DOI:10.1371/journal.pone.0178054
BACKGROUND
Daily directly-observed therapy (DOT) is recommended for rifampicin-resistant tuberculosis (RR-TB) patients throughout treatment. We assessed the impact of self-administered treatment (SAT) in a South African township with high rates of RR-TB and HIV.
METHODS
Community-supported SAT for patients who completed the intensive phase was piloted in five primary care clinics in Khayelitsha. We compared final treatment outcomes among RR-TB patients initiating treatment before (standard-of-care (SOC)-cohort, January 2010-July 2013) and after the implementation of the pilot (SAT-cohort, January 2012-December 2014). All patients with outcomes before January 1, 2017 were considered in the analysis of outcomes.
RESULTS
One-hundred-eighteen patients in the SOC-cohort and 174 patients in the SAT-cohort had final RR-TB treatment outcomes; 70% and 73% were HIV-co-infected, respectively. The proportion of patients with a final outcome of loss to follow-up (LTFU) did not differ whether treated in the SOC (25/118, 21.2%) or SAT-cohort (31/174, 17.8%) (P = 0.47). There were no significant differences in the time to 24-month LTFU among HIV-infected and uninfected patients (HR 0.90, 95% CI: 0.51-1.6, P = 0.71), or among patients enrolled in the SOC-cohort versus the SAT-cohort (HR 0.83, 95% CI: 0.49-1.4, P = 0.50) who received at least 6-months of RR-TB treatment.
CONCLUSION
The introduction of SAT during the continuation phase of RR-TB treatment does not adversely affect final RR-TB treatment outcomes in a high TB and HIV-burden setting. This differentiated, patient-centred model of care could be considered in RR-TB programmes to decrease the burden of DOT on patients and health facilities.
Daily directly-observed therapy (DOT) is recommended for rifampicin-resistant tuberculosis (RR-TB) patients throughout treatment. We assessed the impact of self-administered treatment (SAT) in a South African township with high rates of RR-TB and HIV.
METHODS
Community-supported SAT for patients who completed the intensive phase was piloted in five primary care clinics in Khayelitsha. We compared final treatment outcomes among RR-TB patients initiating treatment before (standard-of-care (SOC)-cohort, January 2010-July 2013) and after the implementation of the pilot (SAT-cohort, January 2012-December 2014). All patients with outcomes before January 1, 2017 were considered in the analysis of outcomes.
RESULTS
One-hundred-eighteen patients in the SOC-cohort and 174 patients in the SAT-cohort had final RR-TB treatment outcomes; 70% and 73% were HIV-co-infected, respectively. The proportion of patients with a final outcome of loss to follow-up (LTFU) did not differ whether treated in the SOC (25/118, 21.2%) or SAT-cohort (31/174, 17.8%) (P = 0.47). There were no significant differences in the time to 24-month LTFU among HIV-infected and uninfected patients (HR 0.90, 95% CI: 0.51-1.6, P = 0.71), or among patients enrolled in the SOC-cohort versus the SAT-cohort (HR 0.83, 95% CI: 0.49-1.4, P = 0.50) who received at least 6-months of RR-TB treatment.
CONCLUSION
The introduction of SAT during the continuation phase of RR-TB treatment does not adversely affect final RR-TB treatment outcomes in a high TB and HIV-burden setting. This differentiated, patient-centred model of care could be considered in RR-TB programmes to decrease the burden of DOT on patients and health facilities.
Journal Article > CommentaryFull Text
Lancet Respir Med. 1 March 2022; Volume S2213-2600 (Issue 22); 00121-7.; DOI:10.1016/S2213-2600(22)00121-7
Apolisi I, Mema N, Tyeku N, Beko B, Memani B, et al.
Lancet Respir Med. 1 March 2022; Volume S2213-2600 (Issue 22); 00121-7.; DOI:10.1016/S2213-2600(22)00121-7
Journal Article > LetterAbstract
Eur Respir J. 1 July 2020; Volume 56 (Issue 1); 2000837.; DOI:10.1183/13993003.00837-2020
Mohr-Holland E, Reuter A, Hughes J, Daniels J, Beko B, et al.
Eur Respir J. 1 July 2020; Volume 56 (Issue 1); 2000837.; DOI:10.1183/13993003.00837-2020