Evidence mapPaperPMID 41900449Full record

ArticleMicroorganisms2026

Multidrug-Resistant Tuberculosis in Rural Eastern Cape, South Africa: Clinical, Bacteriological, and Programmatic Predictors of Poor Treatment Outcomes.

Mbulelo Cebisa, Ntandazo Dlatu, Mojisola Clara Hosu, Teke Apalata, Lindiwe Modest Faye

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In one paragraph

Article in Microorganisms, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mbulelo CebisaTB and Associated Research and Innovation Platform (TARIP), WSU-TB Research Group, School of Pathology, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha 5099, South Africa.
Ntandazo DlatuSchool of Public Health, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha 5099, South Africa.
Mojisola Clara HosuTB and Associated Research and Innovation Platform (TARIP), WSU-TB Research Group, School of Pathology, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha 5099, South Africa.ORCID 0000-0002-0388-787X
Teke ApalataTB and Associated Research and Innovation Platform (TARIP), WSU-TB Research Group, School of Pathology, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha 5099, South Africa.ORCID 0000-0002-1329-3864
Lindiwe Modest FayeSchool of Public Health, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha 5099, South Africa.ORCID 0000-0002-7308-4239

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Drug-resistant tuberculosis (DR-TB), particularly multidrug-resistant TB (MDR-TB), remains a significant public health challenge in rural South Africa, where diagnostic and treatment infrastructure is limited. This study aimed to assess resistance patterns, bacillary load, treatment outcomes, and predictors of MDR-TB in the O.R. Tambo District of the Eastern Cape Province. Although isoniazid monoresistant TB (Hr-TB) was identified, its analysis was descriptive due to the limited sample size. A retrospective cohort analysis was conducted on bacteriologically confirmed TB cases (n = 477) diagnosed between 2020 and 2022. The data collected included demographic and clinical variables, smear and culture results, resistance patterns, and treatment outcomes. Drug resistance was categorized as MDR-TB, Hr-TB, or fully susceptible. Outcomes were classified as favorable, unfavorable, lost to follow-up, or ongoing. Logistic regression identified predictors of MDR-TB. DR-TB prevalence was 11.3% (n = 54), with MDR-TB accounting for 10.7% (n = 51) and Hr-TB for 0.6% (n = 3). Prior TB treatment was significantly associated with MDR-TB (adjusted odds ratio [aOR] 4.45, 95% CI: 1.89-10.48). Smear positivity was associated with MDR-TB in univariate analysis (OR 5.0), although its effect diminished in multivariable analysis (aOR 0.40, 95% CI: 0.12-1.36), suggesting confounding by bacillary load. Culture positivity was a strong independent predictor (aOR 27.71, 95% CI: 8.84-86.85), indicating a higher mycobacterial burden among MDR-TB cases. MDR-TB patients had significantly poorer treatment outcomes, with a high rate of unfavorable outcomes and loss to follow-up. MDR-TB dominates the resistance landscape in this rural district, primarily driven by prior treatment and high bacillary loads. The study highlights the need for targeted interventions, including enhanced diagnostic capacity, improved clinical governance, and community-based support systems, to optimize the detection and management of MDR-TB.

Indexed as

bacillary loadclinical governanceculture positivitydrug-resistance predictorsHIV coinfectionmultidrug-resistant tuberculosisretreatment tuberculosisrural health systemstreatment failure

Identifiers

PMID41900449
PMCPMC13028984

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.