Journal
EMERGING INFECTIOUS DISEASES
Volume 27, Issue 3, Pages 728-739Publisher
CENTERS DISEASE CONTROL & PREVENTION
DOI: 10.3201/eid2703.203204
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Funding
- US National Institutes of Health (NIH) [NIH R03AI144335]
- US NIH [NIHGMS T32GM074905, NIH K01AI102944, NIH R01AI152126, K01TW009213, R01AI119037]
- Providence/Boston Center for AIDS Research [P30AI042853]
- National Institute of Allergy and Infectious Diseases
- National Institute on Aging
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institute on Drug Abuse
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Institute on Minority Health and Health Disparities
- National Institute of Mental Health
- National Cancer Institute
- National Institute of General Medical Sciences
- National Institute of Dental and Craniofacial Research
- National Heart, Lung, and Blood Institute
- NIH [NIH T32DA013911]
- Burroughs Wellcome Fund/American Society for Tropical Medicine and Hygiene Postdoctoral Fellowship in Tropical Infectious Diseases
- South African Medical Research Council
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South Africa decentralized treatment for rifampin-resistant tuberculosis in 2011 to reduce hospitalization durations and enable local treatment. A study in Western Cape Province found that patients from Cape Town had shorter hospitalizations and travel distances to TB hospitals compared to those from other areas.
In 2011, South Africa implemented a policy to decentralize treatment for rifampin-resistant tuberculosis (TB) to reduce durations of hospitalization and enable local treatment. We assessed policy implementation in Western Cape Province, where services expanded from 6 specialized TB hospitals to 406 facilities, by analyzing National Health Laboratory Service data on TB during 2012-2015. We calculated the percentage of patients who visited a TB hospital <1 year after rifampin-resistant TB diagnosis, the median duration of their hospitalizations, and the total distance between facilities visited. We assessed temporal changes with linear regression and stratified results by location. Of 2,878 patients, 65% were from Cape Town. In Cape Town, 29% visited a TB hospital; elsewhere, 68% visited a TB hospital. We found that hospitalizations and travel distances were shorter in Cape Town than in the surrounding areas.
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