Implementing a Substance-Use Screening and Intervention Program for People Living with Rifampicin-Resistant Tuberculosis: Pragmatic Experience from Khayelitsha, South Africa
Open accessAbstract
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.
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A scoping review of substance use brief interventions in Africa
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- Authors
- Reuter, A., Beko, B., Memani, B., Furin, J., Daniels, J., Rodriguez, E., Reuter, H., Weich, L., Isaakidis, P., von der Heyden, E., Kock, Y., & Mohr-Holland, E.
- Affiliations
- Médecins Sans Frontières (ZA)
- Harvard University (US)
- University of Cape Town (ZA)
- Stellenbosch University (ZA)
- Médecins Sans Frontières (UG)
- Provincial Government of the Western Cape, Cape Town 8000, South Africa
- Department of Health (ZA)
- Corresponding author
- Reuter, Anja
- Venue
- Tropical Medicine and Infectious Disease
- Publisher
- MDPI AG
- Published
- 2022-01-31
- Volume
- 7
- Issue
- 2
- Pages
- 21
- ISSN
- 2414-6366 (ISSN-L)
- PMC
- PMC8879094
- OpenAlex
- W4210277157
- Cited by
- 9
- References
- 24
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2022: 3
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Tropical Medicine and Infectious Disease (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Open University of Cape Town (University of Cape Town) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- rifampicin-resistant tuberculosis, substance use, SBIRT, alcohol consumption, smoking, ASSIST screening, brief intervention, naltrexone, integrated care, treatment outcomes, loss to follow-up, Khayelitsha
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