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Supporting Information:
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What is the cost of diagnosis and management of drug resistant tuberculosis
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in South Africa?
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Table S1: Frequency and duration of hospitalization, outpatient/clinic visits, treatment and
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diagnostic/monitoring tests during the period of treatment for drug sensitive tuberculosis, multi-
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drug resistant tuberculosis and extensively drug-resistant tuberculosis according to the South African
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Drug Resistant TB guidelines. The reported frequencies refer to the period from diagnosis till the end of
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treatment.
DS-TB
Component
MDR-TB
Smear
Smear
positive
positive
Smear
converters
non converters
negative
Retreatment
ND
ND
ND
ND
Culture
XDR-TB
Culture
converters non converters
Culture
Culture
converters
non converters
6 months
12 months
Hospital inpatient
months (hospitalized
4 months
12 months
patients only)
Hospital,
outpatient
and clinic
Hospital
outpatient visits
ND
ND
ND
ND
visit
frequency Clinic visits
Once per month during
Twice per month during
intensive phase, every 2
intensive phase, every
months in continuation
month in continuation
phase
phase
Once a month for
Once a month for
monitoring ADRs
monitoring ADRs
(outpatients only)
(outpatients only)
1 at diagnosis,
1 at diagnosis,
1 at diagnosis,
1 at diagnosis,
(check-up)
2 during Rx
3 during Rx
3 during Rx
4 during Rx
DOTS clinic visits
1st 2 weeks
1st 2 weeks
1st 2 weeks
daily during
Daily for duration of Rx
Daily for duration of Rx
of Rx
of Rx
of Rx
intensive phase
(outpatients only)
(outpatients only)
2 months
3 months
2 months
3 months
(administering drugs)
Length of
intensive phase
6 months
12 months
and
duration
12 months
(Primary) Cm-Z-Mxf-Eto-Trd-
Treatment
regimen
6 months
PAS-Cfz
Intensive phase
regimen
R-H-Z-E
R-H-Z-E
R-H-Z-E
R-H-Z-E-S
Km-Z-Mxf-Eto-Trd
(Acquired) Cm-Z-Mxf-Clm-AughdH -PAS-Cfz
Length of
4 months
4 months
4 months
5 months
18 months
-
18 months
3 months
continuation phase
(Primary) Z-Mxf-Eto-Trd-PASCfz
Continuation phase
regimen
R-H
R-H
R-H
R-H-E
Z-Mxf-Eto-Trd
(Acquired) Z-Mxf-Clm-AughdH -PAS-Cfz
Sputum smear
microscopy
Sputum
liquid culture
1st line DST
2nd line DST
2 at diagnosis,
2 at diagnosis,
2 at diagnosis,
2 at diagnosis,
At diagnosis and
At diagnosis and
4 during Rx
5 during Rx
5 during Rx
5 during Rx
monthly
monthly
At diagnosis
At diagnosis
At diagnosis and
At diagnosis and
monthly
monthly
ND
At diagnosis
At diagnosis
At diagnosis
ND
ND
ND
After 2 months
of Rx
ND
ND
ND
ND
Diagnostic
and
6 months of Rx
Baseline (every 6 months
Baseline (every 6 months
in HIV-infected)
in HIV-infected)
Baseline
Baseline
Monthly during
1.5 per month during
intensive phase
intensive phase
ND
Every 3 months
Every 3 months
ND
ND
Every 6 months
Every 4 months
ND
ND
Monthly during injectable
Monthly during injectable
at diagnosis
Full blood count
ND
ND
ND
ND
Urea
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
ND
TSH
ND
ND
Audiogram
ND
ND
frequency
Bilirubin)
after
every 6 months
at diagnosis
Liver (ALT, AST,
months of Rx
At diagnosis
every 6 months
ND
potassium)
and after 6
At diagnosis and
ND
Kidney (creatinine,
diagnosis
At diagnosis and
At diagnosis and
Chest X-ray
monitoring
test
At diagnosis
At
CD4 count (HIV
only)
Viral load (HIV only)
phase and every 3 months
phase and every 3 months
in continuation phase
in continuation phase
Once during Rx period
Every 6 months
Every 6 months
Once during Rx period
Every 6 months
Every 6 months
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ND – not routinely done, R - Rifampicin, H - Isoniazid, Z - Pyrazinamide, E - Ethambutol, S - Streptomycin, Km – Kanamycin, Mxf - Moxifloxacin, Eto -
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Ethionamide, Trd – Terizidone, Cm - Capreomycin, PAS – para-amionsalicylic acid, Cfz – Clofazimine, Clm - Clarithromycin, Aug - Augmentin, hdH - high
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dose Isoniazid
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DST – Drug susceptibility test, AST - aspartate aminotransferase, ALT - alanine aminotransferase, TSH – Thyroid stimulating hormone, Rx – Treatment, DOTS
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– Directly Observed Treatment Short Course, ADR - Adverse drug reaction
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