title: A historical review of XDR tuberculosis in the Western Cape province of South Africa.
abstract: There are limited data on the temporal relationship between the regional introduction of multidrug-resistant tuberculosis (MDR-TB) treatment and the subsequent development of extensively drug-resistant TB (XDR-TB). The first XDR-TB case in the Western Cape province of South Africa was recorded in 1992, approximately 5 - 7 years after the regional introduction of MDR-TB-like treatment. Between 1990 and 2002 we identified 48 patients with XDR-TB in the Cape Metropole region of the Western Cape province. Patients were predominantly HIV-uninfected and median survival was 10.8 months. XDR-TB has therefore been present in the Western Cape at least since 1992. These data inform public health policy relevant to the introduction of new anti-TB drug regimens.
authors.affiliation: Lung Infection and Immunity Unit, Division of Pulmonology and UCT Lung Institute, Department of Medicine, University of Cape Town.
authors.forename: Gregory
authors.initials: G
authors.lastname: Symons
authors.forename: Karen
authors.initials: K
authors.lastname: Shean
authors.forename: Elize
authors.initials: E
authors.lastname: Pietersen
authors.forename: Richard
authors.initials: R
authors.lastname: Van Zyl Smit
authors.forename: Lititia
authors.initials: L
authors.lastname: Pool
authors.forename: Malika
authors.initials: M
authors.lastname: Davids
authors.forename: Paul
authors.initials: P
authors.lastname: Willcox
authors.forename: Keertan
authors.initials: K
authors.lastname: Dheda
mesh_terms: D000293:Adolescent; D000328:Adult; D024881:Drug Resistance, Bacterial; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult