{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:28:17Z","timestamp":1790814497509,"version":"4.1.0"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Drug-resistant tuberculosis (DR-TB) continues to threaten TB control efforts in South Africa, particularly in resource-limited provinces such as Limpopo. This study evaluated trends in DR-TB and evaluated treatment outcomes and predictors of unfavorable outcomes from 2011 to 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cross-sectional study using data from 3,528 patients with DR-TB recorded in the Limpopo electronic registry (EDRWeb.net). Descriptive statistics characterized the demographics of the patients and the types of resistance. The associations between variables and outcomes were tested using chi-square analysis and binary logistic regression identified independent predictors of unfavorable treatment outcomes. The study period was stratified into pre-bedaquiline (BDQ) (2011\u20132015) and post-BDQ (2016\u20132019) eras to assess the impact of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Rifampicin-resistant TB (RR-TB) (61.7%) and multidrug-resistant TB (MDR-TB) (32.5%) were the most common. Overall, the success of the treatment was 59.0%, increasing from 54.1% in the pre-BDQ era to 65.3% after BDQ. XDR-TB had the lowest success rate (31.3%). In multivariate analysis, male sex (aOR = 1.12; 95% CI: 1.00\u20131.27), HIV positivity (aOR = 1.28; 95% CI: 1.11\u20131.47), age\u2009\u2265\u200935 years (aOR = 2.01; 95% CI: 1.08\u20133.76), and XDR-TB (aOR = 3.05; 95% CI: 1.65\u20135.65) were independently associated with unfavorable outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Treatment outcomes for DR-TB in Limpopo improved following the introduction of BDQ and shorter all-oral regimens but remain suboptimal, particularly among XDR-TB and HIV co-infected patients. Strengthening TB\/HIV integration, expanding access to new drug regimens, and enhancing early diagnosis are essential to improve outcomes in rural high-burden settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0335600","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T18:32:52Z","timestamp":1763490772000},"page":"e0335600","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Trends and treatment outcomes of drug resistant tuberculosis in Limpopo Province, South Africa (2011\u20132019): A Retrospective Study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5351-7834","authenticated-orcid":true,"given":"Kabelo 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