{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/24499"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/24499","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"Molecular epidemiology, susceptibility profiles, outcomes and transmission dynamics in patients with extensively drug-resistant tuberculosis (XDR-TB) in two provinces of South Africa","abstract":"Background: Recent gains in TB control in South Africa are being reversed by drug-resistant tuberculosis (MDR-TB and XDR-TB), which has a high mortality, is a threat to health care workers, and is prohibitively costly to treat. MDR-TB has been supplanted by XDR-TB, resistance beyond XDR-TB, and programmatically incurable TB. Short-term treatment-related outcomes of XDR-TB patients are known to be poor. However, there are no prospective data to inform longterm treatment-related outcomes, design of effective XDR-TB treatment regimens, and public health interventions required to interrupt transmission. In particular, the utility of certain costly drugs, e.g. capreomycin, for the treatment of XDR-TB remain unclear. There are also few data about how these characteristics differ in HIV-infected persons. Finally, little is known about the experiences of patients living with XDR-TB. This thesis aims to provide best practice evidence to promote drug-resistant TB control in high burden TB and HIV syndemic countries. Methods: We prospectively followed two cohorts of adult South African XDR-TB patients who received hospital and community treatment, which included a capreomycin and PAS-based regimen: (i) cohort A (n=107) from 3 provinces were diagnosed between August 2002 and February 2008 (retrospectively identified) and then prospectively followed up till August 2012; (ii) cohort B (n=273) from 2 provinces were prospectively identified between October 2008 and October 2012 and followed up till October 2014. Strain typing and drug susceptibility testing were performed and treatment-related outcomes were determined. In-depth interviews were conducted with therapeutically destitute patients from cohort B (n=12) and were home-discharged from hospital back to the community.","abstract_html":"Background: Recent gains in TB control in South Africa are being reversed by drug-resistant tuberculosis (MDR-TB and XDR-TB), which has a high mortality, is a threat to health care workers, and is prohibitively costly to treat. MDR-TB has been supplanted by XDR-TB, resistance beyond XDR-TB, and programmatically incurable TB. Short-term treatment-related outcomes of XDR-TB patients are known to be poor. However, there are no prospective data to inform longterm treatment-related outcomes, design of effective XDR-TB treatment regimens, and public health interventions required to interrupt transmission. In particular, the utility of certain costly drugs, e.g. capreomycin, for the treatment of XDR-TB remain unclear. There are also few data about how these characteristics differ in HIV-infected persons. Finally, little is known about the experiences of patients living with XDR-TB. This thesis aims to provide best practice evidence to promote drug-resistant TB control in high burden TB and HIV syndemic countries. Methods: We prospectively followed two cohorts of adult South African XDR-TB patients who received hospital and community treatment, which included a capreomycin and PAS-based regimen: (i) cohort A (n=107) from 3 provinces were diagnosed between August 2002 and February 2008 (retrospectively identified) and then prospectively followed up till August 2012; (ii) cohort B (n=273) from 2 provinces were prospectively identified between October 2008 and October 2012 and followed up till October 2014. Strain typing and drug susceptibility testing were performed and treatment-related outcomes were determined. In-depth interviews were conducted with therapeutically destitute patients from cohort B (n=12) and were home-discharged from hospital back to the community.","abstract_has_math":false,"creators":["Pietersen, Gerbrecht Elizabeth"],"institution":"Department of Medicine","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Dheda, Keertan"],"committee_chairs":[],"committee_members":[],"year":2017,"date_issued":"2017","date_published":"2017","updated_at":"2026-07-22T22:23:42Z","subjects":[],"languages":["eng"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/24499","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Dheda, Keertan"]},{"key":"dc:creator","label":"Author","values":["Pietersen, Gerbrecht Elizabeth"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2017-06-06T09:43:25Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2017-06-06T09:43:25Z"]},{"key":"dc:date.issued","label":"Date","values":["2017"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Department of Medicine"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["University of Cape Town"]},{"key":"dc:type","label":"Dc Type","values":["Doctoral Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Doctoral"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["PhD"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["eng"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/24499"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: Recent gains in TB control in South Africa are being reversed by drug-resistant tuberculosis (MDR-TB and XDR-TB), which has a high mortality, is a threat to health care workers, and is prohibitively costly to treat. MDR-TB has been supplanted by XDR-TB, resistance beyond XDR-TB, and programmatically incurable TB. Short-term treatment-related outcomes of XDR-TB patients are known to be poor. However, there are no prospective data to inform longterm treatment-related outcomes, design of effective XDR-TB treatment regimens, and public health interventions required to interrupt transmission. In particular, the utility of certain costly drugs, e.g. capreomycin, for the treatment of XDR-TB remain unclear. There are also few data about how these characteristics differ in HIV-infected persons. Finally, little is known about the experiences of patients living with XDR-TB. This thesis aims to provide best practice evidence to promote drug-resistant TB control in high burden TB and HIV syndemic countries. Methods: We prospectively followed two cohorts of adult South African XDR-TB patients who received hospital and community treatment, which included a capreomycin and PAS-based regimen: (i) cohort A (n=107) from 3 provinces were diagnosed between August 2002 and February 2008 (retrospectively identified) and then prospectively followed up till August 2012; (ii) cohort B (n=273) from 2 provinces were prospectively identified between October 2008 and October 2012 and followed up till October 2014. Strain typing and drug susceptibility testing were performed and treatment-related outcomes were determined. In-depth interviews were conducted with therapeutically destitute patients from cohort B (n=12) and were home-discharged from hospital back to the community."]},{"key":"dc:title","label":"Title","values":["Molecular epidemiology, susceptibility profiles, outcomes and transmission dynamics in patients with extensively drug-resistant tuberculosis (XDR-TB) in two provinces of South Africa"]}]}],"canonical_facts":{"dc:contributor.advisor":["Dheda, Keertan"],"dc:creator":["Pietersen, Gerbrecht Elizabeth"],"dc:date.accessioned":["2017-06-06T09:43:25Z"],"dc:date.available":["2017-06-06T09:43:25Z"],"dc:date.issued":["2017"],"dc:description.abstract":["Background: Recent gains in TB control in South Africa are being reversed by drug-resistant tuberculosis (MDR-TB and XDR-TB), which has a high mortality, is a threat to health care workers, and is prohibitively costly to treat. MDR-TB has been supplanted by XDR-TB, resistance beyond XDR-TB, and programmatically incurable TB. Short-term treatment-related outcomes of XDR-TB patients are known to be poor. However, there are no prospective data to inform longterm treatment-related outcomes, design of effective XDR-TB treatment regimens, and public health interventions required to interrupt transmission. In particular, the utility of certain costly drugs, e.g. capreomycin, for the treatment of XDR-TB remain unclear. There are also few data about how these characteristics differ in HIV-infected persons. Finally, little is known about the experiences of patients living with XDR-TB. This thesis aims to provide best practice evidence to promote drug-resistant TB control in high burden TB and HIV syndemic countries. Methods: We prospectively followed two cohorts of adult South African XDR-TB patients who received hospital and community treatment, which included a capreomycin and PAS-based regimen: (i) cohort A (n=107) from 3 provinces were diagnosed between August 2002 and February 2008 (retrospectively identified) and then prospectively followed up till August 2012; (ii) cohort B (n=273) from 2 provinces were prospectively identified between October 2008 and October 2012 and followed up till October 2014. Strain typing and drug susceptibility testing were performed and treatment-related outcomes were determined. In-depth interviews were conducted with therapeutically destitute patients from cohort B (n=12) and were home-discharged from hospital back to the community."],"dc:identifier.uri":["http://hdl.handle.net/11427/24499"],"dc:language.iso":["eng"],"dc:publisher.department":["Department of Medicine"],"dc:publisher.institution":["University of Cape Town"],"dc:title":["Molecular epidemiology, susceptibility profiles, outcomes and transmission dynamics in patients with extensively drug-resistant tuberculosis (XDR-TB) in two provinces of South Africa"],"dc:type":["Doctoral Thesis"],"dc:type.qualificationlevel":["Doctoral"],"dc:type.qualificationname":["PhD"]},"updated_at":"2026-07-22T22:23:42Z"}