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Determining the clinical, socio-economic and microbiological characteristics of previously treated tuberculosis patients in Southern Africa

Each year, 10%–20% of patients with tuberculosis (TB) in low and middle-income countries present with previously treated TB and are started on therapy empirically with a standardized five drug retreatment regimen as recommended by the World Health Organization (WHO). TB retreatment patients, are those who present after failing to complete (defaulters), treatment failure (after completion) or relapsing from a previous episode of tuberculosis.

Retreatment patients are at high risk of drug-resistant tuberculosis (DR-TB), especially among those failing treatment. Multi- drug resistant TB (MDR-TB), which is defined as resistant to both isoniazid and rifampicin, particularly threatens the public health of countries with limited resources, such us Mozambique, where adequate diagnosis and treatment are often unavailable. A higher proportion of MDR patients are found among retreatment patients and patients co-infected with HIV.

The socio economic risk factors on TB transmission, treatment adherence and treatment outcome for both HIV + and HIV negative TB retreatment patients and MDR-TB patients are not fully understood. Our knowledge of the true level of MDR-TB incidence among retreatment TB patients and each sub-group of relapses, failures and defaulters, particularly in southern African region, is very limited and requires further investigations. Therefore this study is designed to provide baseline data in 5 Southern African countries - South Africa, Mozambique (CISM), Zambia, Bostwana and Zimbawe - on the profile of retreatment TB patients, including the prevalence of MDR-TB among these patients.

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