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Prevalence, risk factors, and outcomes of Rifampicin-sensitive and Rifampicin-resistant Tuberculosis in the South Kivu province, Democratic Republic of the Congo

Nelson, Jenna A. (2017) Prevalence, risk factors, and outcomes of Rifampicin-sensitive and Rifampicin-resistant Tuberculosis in the South Kivu province, Democratic Republic of the Congo. Master Essay, University of Pittsburgh.

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Background: Tuberculosis (TB) is one of the top ten killers worldwide. Multidrug Resistant TB (MDR-TB), often defined by Rifampicin-resistant TB (RR-TB), threatens the global TB control strategy. The Democratic of the Congo (DRC) is on the World Health Organization’s high burden list. The objective of this study was to estimate the prevalence of RR-TB, explore the risk factors associated with RR-TB, and evaluate the health outcomes associated with different treatment regimens, including a shortened 9-month RR-TB regimen, in the South Kivu Province, DRC.
Methods: Active TB patients were identified through active case finding and GeneXpert diagnostic tests via TB REACH. Patients were prescribed an appropriate treatment regimen based on MDR-TB status and clinical presentation. For this study, demographic information, medical history, and TB status data were extracted from 2012 – 2015 for 16,353 community health center patients. Pearson Chi-square tests and multiple logistic regression analyses were used to analyze risk factors and health outcomes.
Results: The prevalence of TB among this population was 9.4%; the prevalence of RR-TB was 1.0% in the study population, but 10.2% in TB cases. A positive sputum smear result or being a failed, relapse, or retreatment case were risk factors for RR-TB. 88.4% of RS-TB patients on the 6-month regimen, 85.7% of RR-TB patients on the 9-month regimen, and 77.9% of RR-TB patients on the 20/24-month regimen had successful outcomes.
Conclusions: Results from this study showed a similar TB prevalence rate but higher RR-TB rate with a previous TB REACH study and a higher TB prevalence rate than reported by WHO. The risk factors were consistent with past literature. The 9-month RR-TB regimen’s higher success rate is consistent with past literature that this shortened regimen is a feasible and effective way to treat RR-TB. The control of TB depends on the success of high-burden countries implementing efficient diagnosis and prescribing effective treatment. To limit the transmission and virulence of TB and MDR-TB, the implementation of accurate screening programs such as active case finding, testing methods such as GeneXpert, and effective treatment such as the shortened MDR-TB treatment should be a public health priority.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Nelson, Jenna A.jan75@pitt.edujan750000-0003-2803-9751
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairGlynn, Nancy W.glynnn@edc.pitt.eduglynnnUNSPECIFIED
Committee MemberNachega, Jean B.jbn16@pitt.edujbn16UNSPECIFIED
Committee MemberFrank, Linda R.frankie@pitt.edufrankieUNSPECIFIED
Committee MemberBoudreau, Robert M.BoudreauR@edc.pitt.eduBoudreauRUNSPECIFIED
Date: December 2017
Date Type: Completion
Number of Pages: 55
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 17 Jul 2018 16:15
Last Modified: 01 Jan 2021 06:15


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