Characteristics of Recurrent Individuals with Tuberculosis and Risk Factors of Unsuccessful Treatment Outcomes, South Africa, Gauteng and Western Cape Province, 2019 - 2023
1
Public Health, University of the Witwatersrand, Parktown, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3234
ABSTRACT
INTRODUCTION:
Tuberculosis (TB), the second leading cause of death from a single infectious agent globally, remains a critical public health issue, particularly in South Africa, a high-burden country for drug-resistant TB (DR-TB). Recurrent TB episodes and DR-TB pose significant challenges, leading to poorer treatment outcomes, prolonged illness, and increased transmission. This study evaluates the socio-demographic and clinical characteristics, trends, and risk factors associated with recurrent TB and unsuccessful treatment outcomes in Gauteng and Western Cape provinces between 2019 and 2023.
METHODS:
A retrospective cohort study was conducted using data from the Electronic Drug-Resistant Tuberculosis Register (EDRWeb). The study included all DR-TB cases recorded from 2019 to 2023 in Gauteng and Western Cape. Descriptive analyses were performed, followed by univariable analysis to calculate crude odds ratios. Variables with p-values <0.005 were considered statistically significant and included in a multivariable logistic regression, where adjusted odds ratios (aOR) and their corresponding 95% confidence intervals were reported.
RESULTS:
Recurrent TB episodes significantly increased the odds of unsuccessful treatment outcomes, with patients experiencing five episodes facing 2.7 times higher odds (aOR: 2.7, 95% CI: 1.2–6.0). Advanced age, HIV co-infection, and prior treatment failures were key risk factors. Cases from the Western Cape had a higher risk of treatment failure than Gauteng (aOR: 1.5, 95% CI: 1.3–1.6). Short-course regimens demonstrated improved outcomes (aOR: 0.7, 95% CI: 0.6–0.8), highlighting their efficacy.
CONCLUSIONS:
The findings highlight the risks of recurrent TB episodes and DR-TB, particularly in high-burden provinces. Targeted interventions, improved integration of TB and HIV services, and enhanced patient support are essential to improve treatment outcomes. Addressing these challenges is critical to achieving South Africa’s End TB Strategy goals and mitigating the impact of TB on public health.
Tuberculosis (TB), the second leading cause of death from a single infectious agent globally, remains a critical public health issue, particularly in South Africa, a high-burden country for drug-resistant TB (DR-TB). Recurrent TB episodes and DR-TB pose significant challenges, leading to poorer treatment outcomes, prolonged illness, and increased transmission. This study evaluates the socio-demographic and clinical characteristics, trends, and risk factors associated with recurrent TB and unsuccessful treatment outcomes in Gauteng and Western Cape provinces between 2019 and 2023.
METHODS:
A retrospective cohort study was conducted using data from the Electronic Drug-Resistant Tuberculosis Register (EDRWeb). The study included all DR-TB cases recorded from 2019 to 2023 in Gauteng and Western Cape. Descriptive analyses were performed, followed by univariable analysis to calculate crude odds ratios. Variables with p-values <0.005 were considered statistically significant and included in a multivariable logistic regression, where adjusted odds ratios (aOR) and their corresponding 95% confidence intervals were reported.
RESULTS:
Recurrent TB episodes significantly increased the odds of unsuccessful treatment outcomes, with patients experiencing five episodes facing 2.7 times higher odds (aOR: 2.7, 95% CI: 1.2–6.0). Advanced age, HIV co-infection, and prior treatment failures were key risk factors. Cases from the Western Cape had a higher risk of treatment failure than Gauteng (aOR: 1.5, 95% CI: 1.3–1.6). Short-course regimens demonstrated improved outcomes (aOR: 0.7, 95% CI: 0.6–0.8), highlighting their efficacy.
CONCLUSIONS:
The findings highlight the risks of recurrent TB episodes and DR-TB, particularly in high-burden provinces. Targeted interventions, improved integration of TB and HIV services, and enhanced patient support are essential to improve treatment outcomes. Addressing these challenges is critical to achieving South Africa’s End TB Strategy goals and mitigating the impact of TB on public health.
| eISSN: | 2654-1459 |
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