Assessing Local Risk of Rifampicin-Resistant Tuberculosis in KwaZulu-Natal, South Africa Using Lot Quality Assurance Sampling

KwaZulu-Natal (KZN) has the highest burden of notified multidrug-resistant tuberculosis (MDR TB) and extensively drug-resistant (XDR) TB cases in South Africa. A better understanding of spatial heterogeneity in the risk of drug-resistance may help to prioritize local responses. Between July 2012 and...

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Vydáno v:PloS one Ročník 11; číslo 4; s. e0153143
Hlavní autoři: Heidebrecht, Christine L., Podewils, Laura J., Pym, Alexander, Mthiyane, Thuli, Cohen, Ted
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Public Library of Science 06.04.2016
Public Library of Science (PLoS)
Témata:
Adolescent
Adult
Analysis
Antitubercular Agents - therapeutic use
Biology and Life Sciences
Care and treatment
Catchment areas
Catchments
Consultation
Decision making
Disease
Dosage and administration
Drug resistance
Drug therapy
Engineering and Technology
Epidemiology
Female
Health risks
Health surveillance
Heterogeneity
Hospitals
Humans
Immunization
Laboratories
Malaria
Male
Medical diagnosis
Medicine and Health Sciences
Middle Aged
Multidrug resistance
Multidrug resistant organisms
Mycobacterium
People and places
Prospective Studies
Public health
Quality assurance
Quality Control
Research and Analysis Methods
Retrospective Studies
Rifampin
Rifampin - therapeutic use
Risk
Risk Factors
Sample size
Sampling
Sensitivity and Specificity
South Africa - epidemiology
Spatial heterogeneity
Tropical diseases
Tuberculosis
Tuberculosis, Multidrug-Resistant - diagnosis
Tuberculosis, Multidrug-Resistant - drug therapy
Tuberculosis, Multidrug-Resistant - epidemiology
Young Adult
South Africa
United States > US
ISSN:1932-6203, 1932-6203
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Shrnutí:KwaZulu-Natal (KZN) has the highest burden of notified multidrug-resistant tuberculosis (MDR TB) and extensively drug-resistant (XDR) TB cases in South Africa. A better understanding of spatial heterogeneity in the risk of drug-resistance may help to prioritize local responses. Between July 2012 and June 2013, we conducted a two-way Lot Quality Assurance Sampling (LQAS) study to classify the burden of rifampicin (RIF)-resistant TB among incident TB cases notified within the catchment areas of seven laboratories in two northern and one southern district of KZN. Decision rules for classification of areas as having either a high- or low-risk of RIF resistant TB (based on proportion of RIF resistance among all TB cases) were based on consultation with local policy makers. We classified five areas as high-risk and two as low-risk. High-risk areas were identified in both Southern and Northern districts, with the greatest proportion of RIF resistance observed in the northernmost area, the Manguzi community situated on the Mozambique border. Our study revealed heterogeneity in the risk of RIF resistant disease among incident TB cases in KZN. This study demonstrates the potential for LQAS to detect geographic heterogeneity in areas where access to drug susceptibility testing is limited.
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Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: LP AP TC. Performed the experiments: CH TM AP. Analyzed the data: CH LP AP TC. Contributed reagents/materials/analysis tools: TC. Wrote the paper: CH LP AP TM TC.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0153143