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Implementing a Substance-Use Screening and Intervention Program for People Living with Rifampicin-Resistant Tuberculosis: Pragmatic Experience from Khayelitsha, South Africa

Authors :
Anja Reuter
Buci Beko
Boniwe Memani
Jennifer Furin
Johnny Daniels
Erickmar Rodriguez
Hermann Reuter
Lize Weich
Petros Isaakidis
Erin von der Heyden
Yulene Kock
Erika Mohr-Holland
Source :
Tropical Medicine and Infectious Disease, Vol 7, Iss 2, p 21 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Substance use (SU) is associated with poor rifampicin-resistant tuberculosis (RR-TB) treatment outcomes. In 2017, a SBIRT (SU screening-brief intervention-referral to treatment) was integrated into routine RR-TB care in Khayelitsha, South Africa. This was a retrospective study of persons with RR-TB who were screened for SU between 1 July 2018 and 30 September 2020 using the ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). Here we describe outcomes from this program. Persons scoring moderate/high risk received a brief intervention and referral to treatment. Overall, 333 persons were initiated on RR-TB treatment; 38% (n = 128) were screened for SU. Of those, 88% (n = 113/128) reported SU; 65% (n = 83/128) had moderate/high risk SU. Eighty percent (n = 103/128) reported alcohol use, of whom 52% (n = 54/103) reported moderate/high risk alcohol use. Seventy-seven persons were screened for SU within ≤2 months of RR-TB treatment initiation, of whom 69%, 12%, and 12% had outcomes of treatment success, loss to follow-up and death, respectively. Outcomes did not differ between persons with no/low risk and moderate/high risk SU or based on the receipt of naltrexone (p > 0.05). SU was common among persons with RR-TB; there is a need for interventions to address this co-morbidity as part of “person-centered care”. Integrated, holistic care is needed at the community level to address unique challenges of persons with RR-TB and SU.

Details

Language :
English
ISSN :
24146366
Volume :
7
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Tropical Medicine and Infectious Disease
Publication Type :
Academic Journal
Accession number :
edsdoj.07052e021643445cbfb2fc1e87096963
Document Type :
article
Full Text :
https://doi.org/10.3390/tropicalmed7020021