Low treatment initiation rates among multidrug-resistant tuberculosis patients in Gauteng, South Africa, 2011.

SETTING: Gauteng, South Africa. OBJECTIVE: To determine treatment uptake among newly diagnosed multidrug-resistant tuberculosis (MDR-TB) patients and risk markers for non-initiation of treatment. DESIGN: A cross-sectional study was conducted including all newly diagnosed MDR-TB patients in Gauteng Province, South Africa, in 2011. Socio-demographic and clinical characteristics of those who attended Sizwe Hospital, the designated MDR-TB hospital, were extracted from their medical records. District health offices provided data on patients not seen at Sizwe Hospital. Univariate and multivariate analysis were used to determine risk markers for non-initiation of treatment. RESULTS: Of the 942 newly diagnosed MDR-TB patients in Gauteng, only 593 (63%) initiated treatment. Of these, 70 (11.8%) did not maintain treatment up to the fourth month. Among the 349 (37%) who did not initiate treatment, 31.2% died and 46.4% could not be accounted for. Referral for laboratory diagnosis from hospitals, health district of the laboratory diagnosis, human immunodeficiency virus infection and place of residence were independently associated with non-initiation of MDR-TB treatment. CONCLUSION: Untreated patients continue to transmit MDR-TB in the community. These study findings highlight the need to identify and target the causes of non-initiation of treatment in specific settings.

Comparison of chlorine dioxide and dichloroisocyanurate disinfectants for use in the dental setting.

AIM: The aim of this study was to compare the antimicrobial properties of a slow release noncorrosive chlorine dioxide with those of sodium dichloroisocyanurate to establish their possible use in the dental settings. MATERIALS AND METHODS: Disinfectant solutions were prepared according to manufacturers' instructions and tested against Staphylococcus aureus ATCC 29213, Pseudomonas aeruginosa ATCC 27853, Streptococcus mutans NCTC 1044, Candida albicans ATCC 90028, Bacillus subtilis ATCC 15244 spores, Mycobacterium tuberculosis ATCC 25177, Mycobacterium avium subsp. avium ATCC 25291 and Hepatitis B virus using the Standard quantitative suspension test. The shelf-lives of the disinfectants were also determined. RESULTS: Both disinfectants killed all the test organisms within 30 seconds. B. subtilis spores were killed in 2 and 2.5 minutes by chlorine dioxide and sodium dichloroisocya nurate respectively. When diluted solutions of these disinfectants were stored in screw cap bottles, they retained their activity for at least 30 days. CONCLUSIONS: Chlorine dioxide and sodium dichloroisocyanurate containing disinfectants can be used in the denta settings for surfaces and heat sensitive instruments. However, chlorine dioxide is advantageous because it is non-corrosive and the effective concentration is lower than that recommended for sodium dichloroisocyanurate.