ArticleBMC health services research2019
Effects and determinants of tuberculosis drug stockouts in South Africa.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Drug stock-outs in HIV, tuberculosis, and malaria programs: a systematic review.EClinicalMedicine · 2026Review
- Article
- Factors contributing to human and veterinary medicine shortages in developing countries: perspectives of suppliers and regulators in Namibia.Tropical medicine and health · 2025Article
- Malaria prophylaxis stock-outs and birth- and maternal outcomes in Zimbabwe.BMC public health · 2025Article
- The availability of essential medicines in public healthcare facilities in Afghanistan: navigating sociopolitical and geographical challenges.Health policy and planning · 2025Article
- Stockout of anti-TB drugs: Are we going to lose the gains achieved in year 2022-2023?Lung India : official organ of Indian Chest Society · 2024Article
- Tuberculosis commodities supply chain performance in the WHO African region: A scoping review.PLOS global public health · 2024Article
- Predictors of medicine redistribution at public healthcare facilities in King Cetshwayo District, KwaZulu-Natal, South Africa.BMC health services research · 2023Article
- Determinants of stock-outs of first line anti-tuberculosis drugs: the case of public health facilities of Addis Ababa city administration health bureau, Addis Ababa, Ethiopia.BMC health services research · 2022Article
- Impact of socio-economic factors on Tuberculosis treatment outcomes in north-eastern Uganda: a mixed methods study.BMC public health · 2021Observational
- Shortage of essential antimicrobials: a major challenge to global health security.BMJ global health · 2021Review
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe frequent occurrence of medicine stockouts represents a significant obstacle to tuberculosis control in South Africa. Stockouts can lead to treatment alterations or interruptions, which can impact treatment outcomes. This study investigates the determinants and effects of TB drug stockouts and whether poorer districts are disproportionately affected.
methodsTB stockout data, health system indicators and TB treatment outcomes at the district level were extracted from the District Health Barometer for the years 2011, 2012 and 2013. Poverty terciles were constructed using the Census 2011 data to investigate whether stockouts and poor treatment outcomes were more prevalent in more impoverished districts. Fixed-effects regressions were used to estimate the effects of TB stockouts on TB treatment outcomes.
resultsTB stockouts occurred in all provinces but varied across provinces and years. Regression analysis showed a significant association between district per capita income and stockouts: a 10% rise in income was associated with an 8.50% decline in stockout proportions. In terms of consequences, after controlling for unobserved time invariant heterogeneity between districts, a 10% rise in TB drug stockouts was found to lower the cure rate by 2.10% (p < 0.01) and the success rate by 1.42% (p < 0.01). These effects were found to be larger in poorer districts.
conclusionsThe unequal spread of TB drug stockouts adds to the socioeconomic inequality in TB outcomes. Not only are stockouts more prevalent in poorer parts of South Africa, they also have a more severe impact on TB treatment outcomes in poorer districts. This suggests that efforts to cut back TB drug stockouts would not only improve TB treatment outcomes on average, they are also likely to improve equity because a disproportionate share of this burden is currently borne by the poorer districts.
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