Adverse Events of Treatment in a Decentralized Drug-Resistant Tuberculosis Clinic in Johannesburg, South Africa

The overall aim of this study is to review adverse events of decentralized, ambulatory drug-resistant TB (DR-TB) among a high proportion of rifampicin monoresistant TB patients at an outpatient specialized clinic in Johannesburg, South Africa. The study is a retrospective study and differs in two significant ways from previous studies of DR-TB in South Africa.  Firstly, a large proportion of the patients receiving decentralized care have rifampicin mono-resistant TB. All the previous studies of DR-TB outcomes have focused on MDR and XDR TB. Secondly, all of the existing studies of MDR-TB outcomes were conducted prior to the rollout of the Gene Xpert MTB/RIF (“Xpert”) assay, which is a replacement for smear microscopy (AFB) in the initial diagnostic evaluation of TB. It is not known if the shift towards Xpert has altered the landscape of DR-TB treatment by allowing for more rapid diagnosis of drug resistance and shorter delay to initiation of appropriate treatment. This study began after the rollout of gene Xpert.