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dc.contributor.authorNgabonziza, J.-C.S.
dc.contributor.authorHabimana, Y.M.
dc.contributor.authorDecroo, T.
dc.contributor.authorMigambi, P.
dc.contributor.authorDushime, A.
dc.contributor.authorMazarati, J.B.
dc.contributor.authorRigouts, L.
dc.contributor.authorAffolabi, D.
dc.contributor.authorIvan, E.
dc.contributor.authorMeehan, Conor J.
dc.contributor.authorVan Deun, A.
dc.contributor.authorFissette, K.
dc.contributor.authorHabiyambere, I.
dc.contributor.authorNyaruhirira, A.U.
dc.contributor.authorTurate, I.
dc.contributor.authorSemahore, J.M.
dc.contributor.authorNdjeka, N.
dc.contributor.authorMuvunyi, C.M.
dc.contributor.authorCondo, J.U.
dc.contributor.authorGasana, M.
dc.contributor.authorHasker, E.
dc.contributor.authorTorrea, G.
dc.contributor.authorde Jong, B.C.
dc.date.accessioned2020-04-28T09:50:12Z
dc.date.accessioned2020-05-07T09:52:36Z
dc.date.available2020-04-28T09:50:12Z
dc.date.available2020-05-07T09:52:36Z
dc.date.issued2020-03-01
dc.identifier.citationNgabonziza JS, Habimana YM, Decroo T et al (2020) Reduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwanda. International Journal Of Tuberculosis And Lung Disease. 24(3): 329-339.en_US
dc.identifier.urihttp://hdl.handle.net/10454/17785
dc.descriptionYesen_US
dc.description.abstractSETTING: In 2005, in response to the increasing prevalence of rifampicin-resistant tuberculosis (RR-TB) 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.en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.5588/ijtld.19.0298en_US
dc.rights(c) 2020 The Authors. This is an Open Access article distributed under the Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/)en_US
dc.subjectMDR-TBen_US
dc.subjectMDR-TB programmatic managementen_US
dc.subjectMDR-TB treatmenten_US
dc.subjectRwandaen_US
dc.subjectTBen_US
dc.titleReduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwandaen_US
dc.status.refereedYesen_US
dc.date.Accepted2019-08-26
dc.typeArticleen_US
dc.type.versionPublished versionen_US
dc.date.updated2020-04-28T08:50:14Z
refterms.dateFOA2020-05-07T09:53:02Z


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