Implementing a Substance-Use Screening and Intervention Program for People Living with Rifampicin-Resistant Tuberculosis: Pragmatic Experience from Khayelitsha, South Africa
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2022-01-31
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Tropical Medicine and Infectious Disease
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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% (<i>n</i> = 128) were screened for SU. Of those, 88% (<i>n</i> = 113/128) reported SU; 65% (<i>n</i> = 83/128) had moderate/high risk SU. Eighty percent (<i>n</i> = 103/128) reported alcohol use, of whom 52% (<i>n</i> = 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 (<i>p</i> > 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.
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Reuter, A., Beko, B., Memani, B., Furin, J., Daniels, J., Rodriguez, E., Reuter, H. & Weich, L. et al. 2022. Implementing a Substance-Use Screening and Intervention Program for People Living with Rifampicin-Resistant Tuberculosis: Pragmatic Experience from Khayelitsha, South Africa. Tropical Medicine and Infectious Disease. 7(2):21. http://hdl.handle.net/11427/36321