Linkage to care and treatment outcomes for patients diagnosed with drug-susceptible tuberculosis using Xpert MTB/RIF assay in Thaba-Tseka district in Lesotho

OBJECTIVES: To evaluate linkage to care and treatment outcomes of patients with tuberculosis (TB) confirmed by Xpert MTB/RIF assay in Thaba-Tseka district, Lesotho. DESIGN: This was a retrospective cohort study of adult patients diagnosed with drug-susceptible TB using the Xpert MTB/RIF assay at two laboratories in Thaba-Tseka district from January 2016 to December 2020. RESULTS: Six hundred and fifty-five eligible participants were identified for inclusion in this study. Their median age was 40 [interquartile range (IQR) 32–54] years, and 468 (71.45%) were male. Evidence of linkage to care was found for 459 (70.08%) participants, but there was no documentation on treatment initiation for 196 (29.92%) participants. The median time to treatment initiation was 0 days (same-day initiation) (IQR 0–4) and the treatment success rate was 86%. Treatment success was associated with negative sputum smear results after 2, 5 and 6 months (χ(2), P<0.001). The overall mortality rate was 10%, with no trend of mortality reduction. CONCLUSION: There is a need to address the issue of linkage to care of patients diagnosed with TB in Thaba-Tseka district. Efforts should be made to reduce TB mortality in line with the World Health Organization's ‘End TB strategy’ target.