Reduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwanda

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AuteurAFFOLABI, DISSOU
Date d'ajout2026-06-02T16:06:57Z
Date de disponibilite2026-06-02T16:06:57Z
Date de publication2020
ResumeSETTING: In 2005, in response to the increasing prevalence of rifampicin-resistant tuberculosis (RRTB) and poor treatment outcomes, Rwanda initiated the programmatic management of RR-TB, including expanded access to systematic rifampicin drug susceptibility testing (DST) and standardised treatment. OBJECTIVE: To describe trends in diagnostic and treatment delays and estimate their effect on RR-TB mortality. DESIGN: Retrospective analysis of individual-level data including 748 (85.4%) of 876 patients diagnosed with RR-TB notified to the World Health Organization between 1 July 2005 and 31 December 2016 in Rwanda. Logistic regression was used to estimate the effect of diagnostic and therapeutic delays on RR-TB mortality. RESULTS: Between 2006 and 2016, the median diagnostic delay significantly decreased from 88 days to 1 day, and the therapeutic delay from 76 days to 3 days. Simultaneously, RR-TB mortality significantly decreased from 30.8% in 2006 to 6.9% in 2016. Total delay in starting multidrug-resistant TB (MDR-TB) treatment of more than 100 days was associated with more than two-fold higher odds for dying. When delays were long, empirical RR-TB treatment initiation was associated with a lower mortality. CONCLUSION: The reduction of diagnostic and treatment delays reduced RR-TB mortality. We anticipate that universal testing for RR-TB, short diagnostic and therapeutic delays and effective standardised MDR-TB treatment will further decrease RR-TB mortality in Rwanda
DOI10.5588/ijtld.19.0298
Autre identifiantBECDB-9990
URIhttps://dspace.uac.bj/handle/123456789/8889
Languefr
Fait partie deInt J Tuberc Lung Dis
SujetTB
SujetRwanda
SujetMDR-TB programmatic
SujetManagement
SujetMDR-TB diagnosis
SujetMDR-TB treatment
TitreReduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwanda
TypeArticle

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