Trends in drug-resistant tuberculosis in a gold-mining workforce in South Africa, 2002-2008.

Article English OPEN
van Halsema, CL ; Fielding, KL ; Chihota, VN ; Lewis, JJ ; Churchyard, GJ ; Grant, AD (2012)

UNLABELLED: SETTING AND OBJECTIVE: To describe trends in drug-resistant tuberculosis (TB) in two gold-mining workforces, South Africa, 2002-2008. DESIGN: TB programme data analysis. RESULTS: TB case notification rates decreased between 2002 and 2008 from 4006 to 3018 per 100?000 and from 3192 to 2468/100?000 for Companies A and B, respectively. Human immunodeficiency virus (HIV) prevalence exceeded 80% in TB episodes with known status. The proportion of TB episodes with multidrug-resistant TB (MDR-TB) increased from 6/129 (4.7%) to 17/85 (20.0%) among previously treated cases, and from 4/38 (10.4%) to 7/28 (25.0%) in Companies A and B, respectively (tests for trend, Company A, P < 0.001; Company B, P = 0.304). Case notifications of MDR-TB increased during 2002-2008 from 39.8 to 122.9/100?000/year in Company A and from 7.8 to 96.8/100?000/year in Company B. Coverage of second-line drug susceptibility testing (DST) among MDR-TB episodes was low. Previous treatment exposure was a strong risk factor for MDR-TB (prevalence ratio 8.78, 95%CI 5.94-12.97 in previously treated vs. untreated individuals). CONCLUSION: Despite decreasing TB notifications overall, MDR-TB notifications and proportions of episodes with MDR-TB increased in the larger company. Cure must be ensured in first episodes to prevent acquired resistance. Improved coverage of culture, DST and HIV testing is required to allow treatment to be optimised.
  • References (25)
    25 references, page 1 of 3

    1. Corbett EL, Churchyard GJ, Charalambous S, et al. Morbidity and mortality in South African gold miners; impact of untreated disease due to human immunodeficiency virus. Clin Infect Dis 2002;32(9):1251-1258

    2. World Health Organization. Global Tuberculosis Control: WHO Report 2010. World Health Organization, Geneva 2010. (WHO/HTM/TB/2010.07)

    3. Lewis JJ, Charalambous S, Day JH, et al. HIV infection does not affect active case finding of tuberculosis in South African gold miners. Am J Respir Crit Care Med 2009;180(12):1271-1278

    4. Corbett EL, Churchyard GJ, Clayton TC, et al. HIV infection and silicosis: the impact of two potent risk factors on the incidence of mycobacterial disease in South African miners. AIDS 2000; 14(17): 2759-2768

    5. Churchyard GJ, Corbett EL, Kleinschmidt I, Mulder D, De Cock KM. Drug-resistant tuberculosis in South African gold miners: incidence and associated factors. Int J Tuberc Lung Dis 2000;4(5):433-440

    6. Murray J, Sonnenberg P, Shearer S, Godfrey-Faussett P. Drug-resistant pulmonary tuberculosis in a cohort of southern African goldminers with a high prevalence of HIV infection. S Afr Med J 2000;90(4):381-386

    7. Gandhi NR, Moll A, Sturm AW, et al. Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. Lancet 2006;368(9547):1575-1580

    8. Calver AD, Falmer AA, Murray M, et al. Emergence of increased resistance and extensively drug-resistant tuberculosis despite treatment adherence, South Africa. Emerg Infect Dis 2010;16(2):264-271

    9. Fielding, KL, Grant AD, Hayes RJ, Chaisson RE, Corbett EL, Churchyard GJ. Thibela TB: Design and methods of a cluster randomised trial of the effect of community-wide isoniazid preventive therapy on tuberculosis among gold miners in South Africa. Contemp Clin Trials 2011;32(3):382-392

    10. World Health Organization 2008. Anti-tuberculosis drug resistance in the world: fourth global report. World Health Organization, Geneva, 2008. WHO/HTM/TB/2008.394

  • Metrics
    views in OpenAIRE
    views in local repository
    downloads in local repository

    The information is available from the following content providers:

    From Number Of Views Number Of Downloads
    LSHTM Research Online - IRUS-UK 0 47
Share - Bookmark