Voices from the Patients: A Qualitative Study of the Integration of Tuberculosis, Human Immunodeficiency Virus and Primary Healthcare Services in O.R. Tambo District, Eastern Cape, South Africa
- Dlatu, Ntandazo, Oladimeji, Elizabeth Kelechi, Apalata, Teke
- Authors: Dlatu, Ntandazo , Oladimeji, Elizabeth Kelechi , Apalata, Teke
- Date: 2023/10
- Subjects: TB-HIV integration , Challenges and barriers , Patients , O.R. Tambo district , Eastern Cape , South Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13590 , vital:78959 , DOI: https://doi.org/10.3390/idr15020017
- Description: Tuberculosis (TB), a disease of poverty and inequality, is a leading cause of severe illness and death among people with human immunodeficiency virus (HIV). In South Africa, both TB and HIV epidemics have been closely related and persistent, posing a significant burden for healthcare provision. Studies have observed that TB-HIV integration reduces mortality. The operational implementation of integrated services is still challenging. This study aimed to describe patients’ perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities (study sites) in Oliver Reginald (O.R) Tambo Municipality, Eastern Cape province, South Africa. We purposely recruited twenty-nine (29) patients accessing TB and HIV services at the study sites. Data were analyzed using qualitative content analysis and presented as emerging themes. Barriers identified included a lack of health education about TB and HIV; an inadequate counselling for HIV and the antiretroviral drugs (ARVs); and poor quality of services provided by the healthcare facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately.
- Full Text:
- Date Issued: 2023/10
- Authors: Dlatu, Ntandazo , Oladimeji, Elizabeth Kelechi , Apalata, Teke
- Date: 2023/10
- Subjects: TB-HIV integration , Challenges and barriers , Patients , O.R. Tambo district , Eastern Cape , South Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13590 , vital:78959 , DOI: https://doi.org/10.3390/idr15020017
- Description: Tuberculosis (TB), a disease of poverty and inequality, is a leading cause of severe illness and death among people with human immunodeficiency virus (HIV). In South Africa, both TB and HIV epidemics have been closely related and persistent, posing a significant burden for healthcare provision. Studies have observed that TB-HIV integration reduces mortality. The operational implementation of integrated services is still challenging. This study aimed to describe patients’ perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities (study sites) in Oliver Reginald (O.R) Tambo Municipality, Eastern Cape province, South Africa. We purposely recruited twenty-nine (29) patients accessing TB and HIV services at the study sites. Data were analyzed using qualitative content analysis and presented as emerging themes. Barriers identified included a lack of health education about TB and HIV; an inadequate counselling for HIV and the antiretroviral drugs (ARVs); and poor quality of services provided by the healthcare facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately.
- Full Text:
- Date Issued: 2023/10
Analysis of Discordance between Genotypic and Phenotypic Assays for Rifampicin-Resistant Mycobacterium tuberculosis Isolated from Healthcare Facilities in Mthatha
- Bokop, Carine, Faye, M Lindiwe, Apalata, Teke
- Authors: Bokop, Carine , Faye, M Lindiwe , Apalata, Teke
- Date: 2023/07
- Subjects: Xpert MTB/RIF , Line probe assay , MGIT 960 system , Mycobacterium tuburculosis , Discrepant results
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13652 , vital:78963 , DOI: https://doi.org/10.3390/pathogens12070909
- Description: The study sought to determine the rate of discordant results between genotypic and phenotypic tests for the diagnosis of drug-resistant tuberculosis (DR-TB). Sputum samples and cultured isolates from suspected DR-TB patients were, respectively, analyzed for Mycobacterium tuberculosis by Xpert® MTB/RIF (Cepheid, Sunnyvale, CA, USA) and line probe assays (LPA) (Hain, Nehren, Germany). Discrepant rifampicin (RMP)-resistant results were confirmed using BACTEC MGIT960 (BD, New York, NY, USA). Of the 224 RMP-resistant results obtained by Xpert MTB/RIF, 5.4% were susceptible to RMP by LPA. MGIT960 showed a 75% agreement with LPA. The discrepancy was attributed to either heteroresistance or DNA contamination during LPA testing in 58.3% of cases. In 25% of the samples showing agreement in RMP resistance between Xpert MTB/RIF and MGIT960, the discrepancy was attributed to laboratory errors causing false RMP susceptible results with LPA. In 16.7% of the cases, the discrepancy was attributed to false RMP susceptible results with Xpert MTB/RIF. Out of the 224 isolates, susceptibility to isoniazid (INH) by LPA was performed in 73.7% RMP-resistant isolates, of which, 80.6% were resistant. All RMP-resistant isolates by Xpert MTB/RIF were confirmed in 98.5% by LPA if TB isolates were resistant to INH, but were only confirmed in 81.3% if TB isolates were susceptible to INH....
- Full Text:
- Date Issued: 2023/07
- Authors: Bokop, Carine , Faye, M Lindiwe , Apalata, Teke
- Date: 2023/07
- Subjects: Xpert MTB/RIF , Line probe assay , MGIT 960 system , Mycobacterium tuburculosis , Discrepant results
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13652 , vital:78963 , DOI: https://doi.org/10.3390/pathogens12070909
- Description: The study sought to determine the rate of discordant results between genotypic and phenotypic tests for the diagnosis of drug-resistant tuberculosis (DR-TB). Sputum samples and cultured isolates from suspected DR-TB patients were, respectively, analyzed for Mycobacterium tuberculosis by Xpert® MTB/RIF (Cepheid, Sunnyvale, CA, USA) and line probe assays (LPA) (Hain, Nehren, Germany). Discrepant rifampicin (RMP)-resistant results were confirmed using BACTEC MGIT960 (BD, New York, NY, USA). Of the 224 RMP-resistant results obtained by Xpert MTB/RIF, 5.4% were susceptible to RMP by LPA. MGIT960 showed a 75% agreement with LPA. The discrepancy was attributed to either heteroresistance or DNA contamination during LPA testing in 58.3% of cases. In 25% of the samples showing agreement in RMP resistance between Xpert MTB/RIF and MGIT960, the discrepancy was attributed to laboratory errors causing false RMP susceptible results with LPA. In 16.7% of the cases, the discrepancy was attributed to false RMP susceptible results with Xpert MTB/RIF. Out of the 224 isolates, susceptibility to isoniazid (INH) by LPA was performed in 73.7% RMP-resistant isolates, of which, 80.6% were resistant. All RMP-resistant isolates by Xpert MTB/RIF were confirmed in 98.5% by LPA if TB isolates were resistant to INH, but were only confirmed in 81.3% if TB isolates were susceptible to INH....
- Full Text:
- Date Issued: 2023/07
Developing a Model for Integrating of Tuberculosis, Human Immunodeficiency Virus and Primary Healthcare Services in Oliver Reginald (O.R) Tambo District, Eastern Cape, South Africa
- Dlatu, Ntandazo, Longo-Mbenza, Benjamin, Oladimeji, Elizabeth Kelechi, Apalata, Teke
- Authors: Dlatu, Ntandazo , Longo-Mbenza, Benjamin , Oladimeji, Elizabeth Kelechi , Apalata, Teke
- Date: 2023/07
- Subjects: Model developement , TB-HIV integrated model , TB and HIV , Quantitative and qualitative data
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13643 , vital:78964 , DOI: https://doi.org/10.3390/ijerph20115977
- Description: Despite the policy, frameworks for integration exist; integration of TB and HIV services is far from ideal in many resource-limited countries, including South Africa. Few studies have examined the advantages and disadvantages of integrated TB and HIV care in public health facilities, and even fewer have proposed conceptual models for proven integration. This study aims to fill this vacuum by describing the development of a paradigm for integrating TB, HIV, and patient services in a single facility and highlights the importance of TB-HIV services for greater accessibility under one roof. Development of the proposed model occurred in several phases that included assessment of the existing integration model for TB-HIV and synthesis of quantitative and qualitative data from the study sites, which were selected public health facilities in rural and peri-urban areas in the Oliver Reginald (O.R.) Tambo District Municipality in the Eastern Cape, South Africa. Secondary data on clinical outcomes from 2009–2013 TB–HIV were obtained from various sources for the quantitative analysis of Part 1. Qualitative data included focus group discussions with patients and healthcare workers, which were analyzed thematically in Parts 2 and 3. The development of a potentially better model and the validation of this model shows that the district health system was strengthened by the guiding principles of the model, which placed a strong emphasis on inputs, processes, outcomes, and integration effects. The model is adaptable to different healthcare delivery systems but requires the support of patients, providers (professionals and institutions), payers, and policymakers to be successful.
- Full Text:
- Date Issued: 2023/07
- Authors: Dlatu, Ntandazo , Longo-Mbenza, Benjamin , Oladimeji, Elizabeth Kelechi , Apalata, Teke
- Date: 2023/07
- Subjects: Model developement , TB-HIV integrated model , TB and HIV , Quantitative and qualitative data
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13643 , vital:78964 , DOI: https://doi.org/10.3390/ijerph20115977
- Description: Despite the policy, frameworks for integration exist; integration of TB and HIV services is far from ideal in many resource-limited countries, including South Africa. Few studies have examined the advantages and disadvantages of integrated TB and HIV care in public health facilities, and even fewer have proposed conceptual models for proven integration. This study aims to fill this vacuum by describing the development of a paradigm for integrating TB, HIV, and patient services in a single facility and highlights the importance of TB-HIV services for greater accessibility under one roof. Development of the proposed model occurred in several phases that included assessment of the existing integration model for TB-HIV and synthesis of quantitative and qualitative data from the study sites, which were selected public health facilities in rural and peri-urban areas in the Oliver Reginald (O.R.) Tambo District Municipality in the Eastern Cape, South Africa. Secondary data on clinical outcomes from 2009–2013 TB–HIV were obtained from various sources for the quantitative analysis of Part 1. Qualitative data included focus group discussions with patients and healthcare workers, which were analyzed thematically in Parts 2 and 3. The development of a potentially better model and the validation of this model shows that the district health system was strengthened by the guiding principles of the model, which placed a strong emphasis on inputs, processes, outcomes, and integration effects. The model is adaptable to different healthcare delivery systems but requires the support of patients, providers (professionals and institutions), payers, and policymakers to be successful.
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- Date Issued: 2023/07
Models of integration of TB and HIV services and factors associated with perceived quality of TB-HIV integrated service delivery in O.R Tambo District, South Africa
- Dlatu, Ntandazo, Longo-Mbenza, Benjamin, Apalata, Teke
- Authors: Dlatu, Ntandazo , Longo-Mbenza, Benjamin , Apalata, Teke
- Date: 2023/07
- Subjects: Tuberculosis , HIV , HIV/TB integration , Healthcare services
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13560 , vital:78954 , DOI: https://doi.org/10.1186/s12913-023-09748-2
- Description: Background Tuberculosis is the leading infectious cause of death among people living with HIV. Reducing morbidity and mortality from HIV-associated TB requires strong collaboration between TB and HIV services at all levels with fully integrated, people-centered models of care. Methods This is a qualitative study design using principles of ethnography and the application of aggregate complexity theory. A total of 54 individual interviews with healthcare workers and patients took place in five primary healthcare facilities in the O.R. Tambo district. The participants were purposively selected until the data reached saturation point, and all interviews were tape-recorded. Quantitative analysis of qualitative data was used after coding ethnographic data, looking for emerging patterns, and counting the number of times a qualitative code occurred. A Likert scale was used to assess the perceived quality of TB/HIV integration. Regression models and canonical discriminant analyses were used to explore the associations between the perceived quality of TB and HIV integrated service delivery and independent predictors of interest using SPSS® version 23.0 (Chicago, IL) considering a type I error of 0.05. Results Of the 54 participants, 39 (72.2%) reported that TB and HIV services were partially integrated while 15 (27.8%) participants reported that TB/HIV services were fully integrated. Using the Likert scale gradient, 23 (42.6%) participants perceived the quality of integrated TB/HIV services as poor while 13 (24.1%) and 18 (33.3%) perceived the quality of TB/HIV integrated services as moderate and excellent, respectively. Multiple linear regression analysis showed that access to healthcare services was significantly and independently associated with the perceived quality of integrated TB/HIV services following the equation: Y=3.72–0.06X (adjusted R2=23%, p-value=0.001). Canonical discriminant analysis (CDA) showed that in all 5 municipal facilities, long distances to healthcare facilities leading to reduced access to services were significantly more likely to be the most impeding factor, which is negatively influencing the perceived quality of integrated TB/HIV services, with functions’ coefficients ranging from 9.175 in Mhlontlo to 16.514 in KSD (Wilk’s Lambda=0.750, p=0.043).
- Full Text:
- Date Issued: 2023/07
- Authors: Dlatu, Ntandazo , Longo-Mbenza, Benjamin , Apalata, Teke
- Date: 2023/07
- Subjects: Tuberculosis , HIV , HIV/TB integration , Healthcare services
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13560 , vital:78954 , DOI: https://doi.org/10.1186/s12913-023-09748-2
- Description: Background Tuberculosis is the leading infectious cause of death among people living with HIV. Reducing morbidity and mortality from HIV-associated TB requires strong collaboration between TB and HIV services at all levels with fully integrated, people-centered models of care. Methods This is a qualitative study design using principles of ethnography and the application of aggregate complexity theory. A total of 54 individual interviews with healthcare workers and patients took place in five primary healthcare facilities in the O.R. Tambo district. The participants were purposively selected until the data reached saturation point, and all interviews were tape-recorded. Quantitative analysis of qualitative data was used after coding ethnographic data, looking for emerging patterns, and counting the number of times a qualitative code occurred. A Likert scale was used to assess the perceived quality of TB/HIV integration. Regression models and canonical discriminant analyses were used to explore the associations between the perceived quality of TB and HIV integrated service delivery and independent predictors of interest using SPSS® version 23.0 (Chicago, IL) considering a type I error of 0.05. Results Of the 54 participants, 39 (72.2%) reported that TB and HIV services were partially integrated while 15 (27.8%) participants reported that TB/HIV services were fully integrated. Using the Likert scale gradient, 23 (42.6%) participants perceived the quality of integrated TB/HIV services as poor while 13 (24.1%) and 18 (33.3%) perceived the quality of TB/HIV integrated services as moderate and excellent, respectively. Multiple linear regression analysis showed that access to healthcare services was significantly and independently associated with the perceived quality of integrated TB/HIV services following the equation: Y=3.72–0.06X (adjusted R2=23%, p-value=0.001). Canonical discriminant analysis (CDA) showed that in all 5 municipal facilities, long distances to healthcare facilities leading to reduced access to services were significantly more likely to be the most impeding factor, which is negatively influencing the perceived quality of integrated TB/HIV services, with functions’ coefficients ranging from 9.175 in Mhlontlo to 16.514 in KSD (Wilk’s Lambda=0.750, p=0.043).
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- Date Issued: 2023/07
Epidemiology of the Acceptance of Anti COVID-19 Vaccine in Urban and Rural Settings in Cameroon
- Djuikoue, Ingrid Cecile, Wouambo, Kamga Rodrigue, Pahane, Mbiada Majeste, Fenkenge, Demanou Blaise, Nana, Seugnou Cedric, Nzenya, Djamfa Joelle, Kamgne, Fotso Flore, Toutcho, Ngalani Cedric, Pokam, Thumamo D Benjamin, Apalata, Teke
- Authors: Djuikoue, Ingrid Cecile , Wouambo, Kamga Rodrigue , Pahane, Mbiada Majeste , Fenkenge, Demanou Blaise , Nana, Seugnou Cedric , Nzenya, Djamfa Joelle , Kamgne, Fotso Flore , Toutcho, Ngalani Cedric , Pokam, Thumamo D Benjamin , Apalata, Teke
- Date: 2023
- Subjects: Vaccination , Acceptance , COVID-19 , Epidemiology , Cameroon , Urban area , Rural area
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13648 , vital:78966 , DOI: https://doi.org/10.3390/vaccines11030625
- Description: The COVID-19 pandemic rapidly evolved in December 2019 and to prevent its spread, effective vaccines were produced and made available to the population. Despite their availability so far in Cameroon, the vaccination coverage remains low. This study aimed at describing the epidemiology of the acceptance of vaccines against COVID-19 in some urban and rural areas of Cameroon. A cross-sectional, descriptive and analytical survey was conducted from March 2021 to August 2021 targeting unvaccinated individuals from urban and rural area. After receiving appropriate administrative authorizations and an ethical clearance from the Institutional Review Board (or Ethics Committee) of Douala University (N◦ 3070CEI-Udo/05/2022/M), a cluster sam pling at many degrees was performed and a language-adapted questionnaire was completed by each consenting participant. Data were analyzed using Epi info version 7.2.2.6 software and for p-values...
- Full Text:
- Date Issued: 2023
- Authors: Djuikoue, Ingrid Cecile , Wouambo, Kamga Rodrigue , Pahane, Mbiada Majeste , Fenkenge, Demanou Blaise , Nana, Seugnou Cedric , Nzenya, Djamfa Joelle , Kamgne, Fotso Flore , Toutcho, Ngalani Cedric , Pokam, Thumamo D Benjamin , Apalata, Teke
- Date: 2023
- Subjects: Vaccination , Acceptance , COVID-19 , Epidemiology , Cameroon , Urban area , Rural area
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13648 , vital:78966 , DOI: https://doi.org/10.3390/vaccines11030625
- Description: The COVID-19 pandemic rapidly evolved in December 2019 and to prevent its spread, effective vaccines were produced and made available to the population. Despite their availability so far in Cameroon, the vaccination coverage remains low. This study aimed at describing the epidemiology of the acceptance of vaccines against COVID-19 in some urban and rural areas of Cameroon. A cross-sectional, descriptive and analytical survey was conducted from March 2021 to August 2021 targeting unvaccinated individuals from urban and rural area. After receiving appropriate administrative authorizations and an ethical clearance from the Institutional Review Board (or Ethics Committee) of Douala University (N◦ 3070CEI-Udo/05/2022/M), a cluster sam pling at many degrees was performed and a language-adapted questionnaire was completed by each consenting participant. Data were analyzed using Epi info version 7.2.2.6 software and for p-values...
- Full Text:
- Date Issued: 2023
Prolongation of Acid-Fast Bacilli Sputum Smear Positivity in Patients with Multidrug Pulmonary Tuberculosis
- Mvo, Sidwell, Bokop, Carine, Longo-Mbenza, Benjamin, Vasaikar, D Sandeep, Apalata, Teke
- Authors: Mvo, Sidwell , Bokop, Carine , Longo-Mbenza, Benjamin , Vasaikar, D Sandeep , Apalata, Teke
- Date: 2023
- Subjects: MDR-TB , HIV status , Time to sputum microscopy conversion , Smear positivity
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13621 , vital:78968 , DOI: https://doi.org/10.3390/pathogens12091133
- Description: The study sought to determine factors associated with prolonged smear positivity in multidrug-resistant tuberculosis (MDR-TB) patients following appropriate management. Newly diagnosed patients were enrolled between June 2017 and May 2018. Sputum samples were collected for Xpert® MTB/RIF and line probe assays (LiPAs). Microscopic tests were performed at baseline and 4, 8, and 12 weeks post-anti-TB therapy. Of the 200 patients, 114 (57%) were HIV-positive. After 12 weeks of treatment, there was a significant microscopy conversion rate among DS-TB patients compared to MDR-TB patients irrespective of their HIV status (p = 0.0013). All MDR-TB patients who had a baseline smear grade ranging from scanty to +1 converted negative, while 25% ranging from +2 to +3 remained positive until the end of 12 weeks (p = 0.014)…
- Full Text:
- Date Issued: 2023
- Authors: Mvo, Sidwell , Bokop, Carine , Longo-Mbenza, Benjamin , Vasaikar, D Sandeep , Apalata, Teke
- Date: 2023
- Subjects: MDR-TB , HIV status , Time to sputum microscopy conversion , Smear positivity
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13621 , vital:78968 , DOI: https://doi.org/10.3390/pathogens12091133
- Description: The study sought to determine factors associated with prolonged smear positivity in multidrug-resistant tuberculosis (MDR-TB) patients following appropriate management. Newly diagnosed patients were enrolled between June 2017 and May 2018. Sputum samples were collected for Xpert® MTB/RIF and line probe assays (LiPAs). Microscopic tests were performed at baseline and 4, 8, and 12 weeks post-anti-TB therapy. Of the 200 patients, 114 (57%) were HIV-positive. After 12 weeks of treatment, there was a significant microscopy conversion rate among DS-TB patients compared to MDR-TB patients irrespective of their HIV status (p = 0.0013). All MDR-TB patients who had a baseline smear grade ranging from scanty to +1 converted negative, while 25% ranging from +2 to +3 remained positive until the end of 12 weeks (p = 0.014)…
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- Date Issued: 2023
Spatial Distribution of Drug-Resistant Mycobacterium tuberculosis Infections in Rural Eastern Cape Province of South Africa
- Faye, M Lindiwe, Hosu, C Mojisola, Vasaikar, Sandeep, Dippenaar, Anzaan, Oostvogels, Selien, Warren, M Rob, Apalata, Teke
- Authors: Faye, M Lindiwe , Hosu, C Mojisola , Vasaikar, Sandeep , Dippenaar, Anzaan , Oostvogels, Selien , Warren, M Rob , Apalata, Teke
- Date: 2023
- Subjects: Tuberculosis , Spatial analysis , Mutations , Spoligotypes , Heteroresistance
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13642 , vital:78969 , DOI: https://doi.org/10.3390/pathogens12030475
- Description: Tuberculosis (TB), an infectious airborne disease caused by Mycobacterium tuberculosis (Mtb), is a serious public health threat reported as the leading cause of morbidity and mortality worldwide. South Africa is a high-TB-burden country with TB being the highest infectious disease killer. This study investigated the distribution of Mtb mutations and spoligotypes in rural Eastern Cape Province. The Mtb isolates included were 1157 from DR-TB patients and analysed by LPA followed by spoligotyping of 441 isolates. The distribution of mutations and spoligotypes was done by spatial analysis. The rpoB gene had the highest number of mutations. The distribution of rpoB and katG mutations was more prevalent in four healthcare facilities, inhA mutations were more prevalent in three healthcare facilities, and heteroresistant isolates were more prevalent in five healthcare facilities. The Mtb was genetically diverse with Beijing more prevalent and largely distributed. Spatial analysis and mapping of gene mutations and spoligotypes revealed a better picture of distribution.
- Full Text:
- Date Issued: 2023
- Authors: Faye, M Lindiwe , Hosu, C Mojisola , Vasaikar, Sandeep , Dippenaar, Anzaan , Oostvogels, Selien , Warren, M Rob , Apalata, Teke
- Date: 2023
- Subjects: Tuberculosis , Spatial analysis , Mutations , Spoligotypes , Heteroresistance
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13642 , vital:78969 , DOI: https://doi.org/10.3390/pathogens12030475
- Description: Tuberculosis (TB), an infectious airborne disease caused by Mycobacterium tuberculosis (Mtb), is a serious public health threat reported as the leading cause of morbidity and mortality worldwide. South Africa is a high-TB-burden country with TB being the highest infectious disease killer. This study investigated the distribution of Mtb mutations and spoligotypes in rural Eastern Cape Province. The Mtb isolates included were 1157 from DR-TB patients and analysed by LPA followed by spoligotyping of 441 isolates. The distribution of mutations and spoligotypes was done by spatial analysis. The rpoB gene had the highest number of mutations. The distribution of rpoB and katG mutations was more prevalent in four healthcare facilities, inhA mutations were more prevalent in three healthcare facilities, and heteroresistant isolates were more prevalent in five healthcare facilities. The Mtb was genetically diverse with Beijing more prevalent and largely distributed. Spatial analysis and mapping of gene mutations and spoligotypes revealed a better picture of distribution.
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- Date Issued: 2023
Treatment Outcomes and Associated Factors among Tuberculosis Patients from Selected Rural Eastern Cape Hospitals: An Ambidirectional Study
- Faye, M Lindiwe, Hosu, C Mojisola, Iruedo, Joshua, Nokoyo, A Kolisa, Tsuro, Urgent, Apalata, Teke
- Authors: Faye, M Lindiwe , Hosu, C Mojisola , Iruedo, Joshua , Nokoyo, A Kolisa , Tsuro, Urgent , Apalata, Teke
- Date: 2023
- Subjects: Treatment outcomes , DR-TB, MDR-TB, TB-HIV , Co-infection , Treatment success rate
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13637 , vital:78967 , DOI: https://doi.org/10.3390/tropicalmed8060315
- Description: An essential metric for determining the efficacy of tuberculosis (TB) control programs is the evaluation of TB treatment outcomes; this study was conducted to investigate treatment outcomes and associated factors among tuberculosis patients in rural areas of Eastern Cape, South Africa. Assessing treatment outcomes is fundamental to facilitating the End TB Strategy’s set target. Clinic records from 457 patients with DR-TB were examined for data collection while 101 patients were followed up prospectively. Data were analyzed using Stata version 17.0. The odds ratio and 95% confidence interval were calculated to check the association between variables. p ≤ 0.05 was considered statistically significant. Of the 427 participants, 65.8% had successful treatment whilst 34.2% had unsuccessful TB treatment. A total of 61.2% and 39% of the HIV-positive and HIV-negative participants had a successful TB treatment whilst 66% and 34% of both HIV-negative and positive participants had unsuccessful TB treatment. From the 101 patients that were followed up, smokers took longer to have treatment outcomes compared to non-smokers. In the study with HIV/TB co-infection, men predominated. HIV and tuberculosis co-infection made therapy difficult with unfavorable effects on TB management. The treatment success rate (65.8%) was lower than the WHO threshold standard with a high proportion of patients being lost to the follow up. The co-infection of tuberculosis and HIV resulted in undesirable treatment outcomes. Strengthening TB surveillance and control is recommended.
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- Date Issued: 2023
- Authors: Faye, M Lindiwe , Hosu, C Mojisola , Iruedo, Joshua , Nokoyo, A Kolisa , Tsuro, Urgent , Apalata, Teke
- Date: 2023
- Subjects: Treatment outcomes , DR-TB, MDR-TB, TB-HIV , Co-infection , Treatment success rate
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13637 , vital:78967 , DOI: https://doi.org/10.3390/tropicalmed8060315
- Description: An essential metric for determining the efficacy of tuberculosis (TB) control programs is the evaluation of TB treatment outcomes; this study was conducted to investigate treatment outcomes and associated factors among tuberculosis patients in rural areas of Eastern Cape, South Africa. Assessing treatment outcomes is fundamental to facilitating the End TB Strategy’s set target. Clinic records from 457 patients with DR-TB were examined for data collection while 101 patients were followed up prospectively. Data were analyzed using Stata version 17.0. The odds ratio and 95% confidence interval were calculated to check the association between variables. p ≤ 0.05 was considered statistically significant. Of the 427 participants, 65.8% had successful treatment whilst 34.2% had unsuccessful TB treatment. A total of 61.2% and 39% of the HIV-positive and HIV-negative participants had a successful TB treatment whilst 66% and 34% of both HIV-negative and positive participants had unsuccessful TB treatment. From the 101 patients that were followed up, smokers took longer to have treatment outcomes compared to non-smokers. In the study with HIV/TB co-infection, men predominated. HIV and tuberculosis co-infection made therapy difficult with unfavorable effects on TB management. The treatment success rate (65.8%) was lower than the WHO threshold standard with a high proportion of patients being lost to the follow up. The co-infection of tuberculosis and HIV resulted in undesirable treatment outcomes. Strengthening TB surveillance and control is recommended.
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- Date Issued: 2023
In vitro antimicrobial photodynamic inactivation of multidrugresistant Acinetobacter baumannii biofilm using Protoporphyrin IX and Methylene blue
- Anane, Yaw Adjei, Apalata, Teke, Vasaikar, Sandeep, Okuthe, Grace Emily, Songca, Sandile Phinda
- Authors: Anane, Yaw Adjei , Apalata, Teke , Vasaikar, Sandeep , Okuthe, Grace Emily , Songca, Sandile Phinda
- Date: 2020
- Language: English
- Identifier: http://hdl.handle.net/11260/2273 , vital:41315
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- Authors: Anane, Yaw Adjei , Apalata, Teke , Vasaikar, Sandeep , Okuthe, Grace Emily , Songca, Sandile Phinda
- Date: 2020
- Language: English
- Identifier: http://hdl.handle.net/11260/2273 , vital:41315
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Molecular Detection of Carbapenemase-Encoding Genes in Multidrug-Resistant Acinetobacter baumannii Clinical Isolates in South Africa
- Anane, Yaw Adjei, Apalata, Teke, Vasaikar, Sandeep, Okuthe, Grace Emily, Songca, Sandile
- Authors: Anane, Yaw Adjei , Apalata, Teke , Vasaikar, Sandeep , Okuthe, Grace Emily , Songca, Sandile
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/2263 , vital:41314
- Description: https://www.hindawi.com/journals/ijmicro/2020/7380740/
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- Authors: Anane, Yaw Adjei , Apalata, Teke , Vasaikar, Sandeep , Okuthe, Grace Emily , Songca, Sandile
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/2263 , vital:41314
- Description: https://www.hindawi.com/journals/ijmicro/2020/7380740/
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Molecular Detection of Carbapenemase-Encoding Genes in Multidrug-Resistant Acinetobacter baumannii Clinical Isolates in South Africa
- Anane, Yaw Adjei, Okuthe, Grace Emily, Apalata, Teke, Vasaikar, Sandeep, Songca, Sandile
- Authors: Anane, Yaw Adjei , Okuthe, Grace Emily , Apalata, Teke , Vasaikar, Sandeep , Songca, Sandile
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4351 , vital:44108
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- Authors: Anane, Yaw Adjei , Okuthe, Grace Emily , Apalata, Teke , Vasaikar, Sandeep , Songca, Sandile
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4351 , vital:44108
- Full Text:
The association between HIV tri-therapy with the development of Type-2 Diabetes Mellitus in a rural South African district: A case-control study
- Bam, Nokwanda E, Mabunda, Sikhumbuzo A, Ntsaba, Jafta, Apalata, Teke, Monatshila, Sibusisu C, Chitha, Wesile
- Authors: Bam, Nokwanda E , Mabunda, Sikhumbuzo A , Ntsaba, Jafta , Apalata, Teke , Monatshila, Sibusisu C , Chitha, Wesile
- Date: 2020
- Subjects: Type 2 diabetes , AIDS (Disease) , Rural health
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/4008 , vital:43983 , https://doi.org/10.1371/journal.pone.0244067
- Description: Combination antiretroviral drugs(cARVs)prolong patients’ lives but are unfortunately thought to increase complications related to metabolic disorders including type-2 Diabetes Mellitus(DM).We sought to confirm the association of cARVs with type-2DM and ascertain the extent of this association in a rural South African setting. A case-control study of 177 (33.33%) cases with HIV/AIDS and type-2 DM were selected and compared with 354 (66.67%) non-DM HIV/AIDS unmatched controls from a rural district of South Africa’s third most populous province (Eastern Cape). Cases were identified from community health centres using the district health information system, and controls were identified using simple random sampling from the same health facilities. Odds Ratios (OR), together with 95% confidence intervals, were calculated for all the univariable and multivariable logistic analyses. This study found that cARVs significantly increased the occurrence of type-2 DM among HIV patients. Patients on protease inhibitors (PIs) were at least 21 times significantly more likely to be diabetic than those on the fixed dose combination (FDC); those on stavudine (D4T) and zidovudine (AZT) were 2.45 times and 9.44 times respectively more likely to be diabetic than those on FDC. The odds of diabetes increased by more than three-folds for those who had been on antiretroviral drugs for more than 6 years.
- Full Text:
- Date Issued: 2020
- Authors: Bam, Nokwanda E , Mabunda, Sikhumbuzo A , Ntsaba, Jafta , Apalata, Teke , Monatshila, Sibusisu C , Chitha, Wesile
- Date: 2020
- Subjects: Type 2 diabetes , AIDS (Disease) , Rural health
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/4008 , vital:43983 , https://doi.org/10.1371/journal.pone.0244067
- Description: Combination antiretroviral drugs(cARVs)prolong patients’ lives but are unfortunately thought to increase complications related to metabolic disorders including type-2 Diabetes Mellitus(DM).We sought to confirm the association of cARVs with type-2DM and ascertain the extent of this association in a rural South African setting. A case-control study of 177 (33.33%) cases with HIV/AIDS and type-2 DM were selected and compared with 354 (66.67%) non-DM HIV/AIDS unmatched controls from a rural district of South Africa’s third most populous province (Eastern Cape). Cases were identified from community health centres using the district health information system, and controls were identified using simple random sampling from the same health facilities. Odds Ratios (OR), together with 95% confidence intervals, were calculated for all the univariable and multivariable logistic analyses. This study found that cARVs significantly increased the occurrence of type-2 DM among HIV patients. Patients on protease inhibitors (PIs) were at least 21 times significantly more likely to be diabetic than those on the fixed dose combination (FDC); those on stavudine (D4T) and zidovudine (AZT) were 2.45 times and 9.44 times respectively more likely to be diabetic than those on FDC. The odds of diabetes increased by more than three-folds for those who had been on antiretroviral drugs for more than 6 years.
- Full Text:
- Date Issued: 2020
Prevalence and molecular analysis of multidrug-resistant Acinetobacter baumannii in the extra-hospital environment in Mthatha, South Africa
- Adjei, Anane Yaw, Apalata, Teke, Vasaikar, Sandeep, Okuthe, Grace Emily, Songca, Sandile
- Authors: Adjei, Anane Yaw , Apalata, Teke , Vasaikar, Sandeep , Okuthe, Grace Emily , Songca, Sandile
- Date: 2019
- Subjects: Acinetobacter baumannii , Carbapenemase-encoding genes , Multidrug-resistance , ISAba1 , intI1
- Language: English
- Type: article , text
- Identifier: http://hdl.handle.net/11260/2409 , vital:41457 , https://doi.org/10.1016/j.bjid.2019.09.004
- Description: The presence of Acinetobacter baumannii outside hospitals remains unclear. This study aimed to determine the prevalence of multidrug-resistance (MDR) A. baumannii in the extra-hospital environment in Mthatha, South Africa and to investigate the frequency of carbapenemase-encoding genes. Material and Methods: From August 2016 to July 2017 a total of 598 abattoir samples and 689 aquatic samples were collected and analyzed presumptively by cultural methods for the presence of A. baumannii using CHROMagarTM Acinetobacter medium. Species identification was performed by autoSCAN-4 (Dade Behring Inc., IL) and confirmed by the detection of their intrinsic blaOXA-51 gene. Confirmed MDR A. baumannii isolates were screened for the presence of carbapenemase-encoding genes, ISAba1 insertion sequence and integrase intI1. Results: In total, 248 (19.3%) Acinetobacter species were isolated. Acinetobacter. baumannii was detected in 183 (73.8%) of which 85 (46.4%) and 98 (53.6%) were recovered from abattoir and aquatic respectively. MDR A. baumannii was detected in 56.5% (48/85) abattoir isolates and 53.1% (52/98) aquatic isolates. Isolates showed high resistance to antimicrobials most frequently used to treat Acinetobacter infections such as piperacillin/tazobactam; abattoir (98% of isolates resistant), aquatic (94% of isolates resistant), ceftazidime (84%, 83%), ciprofloxacin (71%, 70%), amikacin (41%, 42%), imipenem (75%, 73%), and meropenem (74%, 71%). All the isolates were susceptible to tigecycline and colistin. All the isolates carried blaOXA-51-like. The blaOXA-23 was detected in 32 (66.7%) abattoir isolates and 11 (21.2%) aquatic isolates. The blaOXA-58-like was positive in 7 (14.6%) and 4 (7.7%) abattoir and aquatic isolates, respectively. Both groups of isolates lacked blaOXA-24-like, blaIMP-type, blaVIM-type, blaNDM-1, blaSIM, blaAmpC, ISAba1 and inI1. Isolates showed high level of Multiple Antibiotic Resistance Index (MARI) ranging from 0.20-0.52. Conclusion: Extra-hospital sources such as abattoir and aquatic environments may be a vehicle of spread of MDR A. baumannii strains in the community and hospital settings.
- Full Text:
- Date Issued: 2019
- Authors: Adjei, Anane Yaw , Apalata, Teke , Vasaikar, Sandeep , Okuthe, Grace Emily , Songca, Sandile
- Date: 2019
- Subjects: Acinetobacter baumannii , Carbapenemase-encoding genes , Multidrug-resistance , ISAba1 , intI1
- Language: English
- Type: article , text
- Identifier: http://hdl.handle.net/11260/2409 , vital:41457 , https://doi.org/10.1016/j.bjid.2019.09.004
- Description: The presence of Acinetobacter baumannii outside hospitals remains unclear. This study aimed to determine the prevalence of multidrug-resistance (MDR) A. baumannii in the extra-hospital environment in Mthatha, South Africa and to investigate the frequency of carbapenemase-encoding genes. Material and Methods: From August 2016 to July 2017 a total of 598 abattoir samples and 689 aquatic samples were collected and analyzed presumptively by cultural methods for the presence of A. baumannii using CHROMagarTM Acinetobacter medium. Species identification was performed by autoSCAN-4 (Dade Behring Inc., IL) and confirmed by the detection of their intrinsic blaOXA-51 gene. Confirmed MDR A. baumannii isolates were screened for the presence of carbapenemase-encoding genes, ISAba1 insertion sequence and integrase intI1. Results: In total, 248 (19.3%) Acinetobacter species were isolated. Acinetobacter. baumannii was detected in 183 (73.8%) of which 85 (46.4%) and 98 (53.6%) were recovered from abattoir and aquatic respectively. MDR A. baumannii was detected in 56.5% (48/85) abattoir isolates and 53.1% (52/98) aquatic isolates. Isolates showed high resistance to antimicrobials most frequently used to treat Acinetobacter infections such as piperacillin/tazobactam; abattoir (98% of isolates resistant), aquatic (94% of isolates resistant), ceftazidime (84%, 83%), ciprofloxacin (71%, 70%), amikacin (41%, 42%), imipenem (75%, 73%), and meropenem (74%, 71%). All the isolates were susceptible to tigecycline and colistin. All the isolates carried blaOXA-51-like. The blaOXA-23 was detected in 32 (66.7%) abattoir isolates and 11 (21.2%) aquatic isolates. The blaOXA-58-like was positive in 7 (14.6%) and 4 (7.7%) abattoir and aquatic isolates, respectively. Both groups of isolates lacked blaOXA-24-like, blaIMP-type, blaVIM-type, blaNDM-1, blaSIM, blaAmpC, ISAba1 and inI1. Isolates showed high level of Multiple Antibiotic Resistance Index (MARI) ranging from 0.20-0.52. Conclusion: Extra-hospital sources such as abattoir and aquatic environments may be a vehicle of spread of MDR A. baumannii strains in the community and hospital settings.
- Full Text:
- Date Issued: 2019
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