The treatment outcomes of tuberculosis among health care workers in a general hospital in the Mpumalanga province, South Africa

Abstract

Background: South Africa is one of the countries in the world with a high burden of tuberculosis (TB). High rates of unfavourable treatment outcomes have remained a feature of TB control in the country. The objective of the current study was to examine the treatment outcomes of TB among health care workers (HCWs) at a rural general hospital in the Mpumalanga province of the country, as well as the clinical care that was provided to the HCWs. The purpose of the study was to identify possible areas for improvement in the TB care services provided to HCWs in the hospital, especially with regard to their clinical management.

Method: The research described in this article consists of a retrospective descriptive study. Relevant data on HCWs diagnosed with TB in the hospital during 2007, the TB care services offered to the HCWs, and the treatment outcomes of the HCWs were captured from the occupational health and TB control programme registers at the hospital onto a data capture sheet for the study and were subsequently analysed manually.

Results: Nine HCWs, eight females and one male, were diagnosed and treated for TB in the hospital during 2007, an incidence rate of 941/100 000. Their ages ranged from 39 to 54 years, with a mean age of 48 years. By occupation, the nine HCWs consisted of six nurses (67%), one porter (11%), one general assistant (11%), and one clerk (11%). Of those treated for TB, seven (78%) had smearpositive pulmonary TB (PTB) and two (22%) had extra-pulmonary TB (EPTB). TB culture and drug susceptibility testing (DST) was undertaken for only one HCW. The HIV status was known for only two (22%) of the nine HCWs under review. Neither of the two HCWs with EPTB had the diagnosis confirmed by bacteriological or histopathological method. The seven HCWs with smear- positive PTB achieved a cure, and the two HCWs with EPTB successfully completed treatment, resulting in a treatment success rate of 100% for the nine HCWs.

Conclusion: The HCWs at Themba Hospital in the Mpumalanga province of South Africa who were diagnosed and treated for TB during 2007 all achieved favourable treatment outcomes. However, in view of the high rate of HIV/TB co-infection and the increasing problem of drug-resistant TB in the country, the clinical care provided to HCWs with TB by the hospital should be improved with regard to routine HIV counselling and testing and the routine early provision of DST. A protocol for the comprehensive management of HCWs with TB is currently undergoing development.