| Autor: |
Bassirou Diarra, Morto Mane, E O Idigbe, Aissatou Gaye Diallo, C. C. Onubogu, Samuel Kudzawu, Jacob Otu, Emmanuel Adebiyi, Yaotse Dagnra, Florian Gehre, Bouke C. de Jong, Nneka Onyejepu, Awa Ba, Gerard Kadanga, Audrey Forson, Ignatius Baldeh, Paulo Rabna, Dezemon Zingue, Salako Kayede, Kodjo Disse, Souleymane Mboup, Martin Antonio, Aderemi Kehinde, Tumani Corrah |
| Rok vydání: |
2017 |
| Předmět: |
|
| Zdroj: |
BMJ Global Health. 2:A32.3-A33 |
| ISSN: |
2059-7908 |
| DOI: |
10.1136/bmjgh-2016-000260.85 |
| Popis: |
Background Multidrug-resistant tuberculosis (MDR-TB) remains a clear threat to TB control. There is a paucity of data on DR-TB for many countries especially in sub-Saharan Africa. The study was undertaken to measure the prevalence of DR-TB, including MDR-TB, from West Africa. Methods Mycobacterial isolates were obtained from consecutive new and previously treated TB patients from Burkina Faso, Ghana, Guinea-Bissau, Mali, Nigeria, Senegal, The Gambia and Togo from December 2012 to December 2014. Phenotypic drug susceptibility testing to first- and second-line anti-TB drugs was performed using BACTEC MGIT 960 system. Results Viable isolates from a total of 44% (416/950) new and 56% (534/950) previously treated TB patients were included. HIV results were available for 599 (63%) with estimated HIV-TB co-infection of 21% (95% CI: 18.2−24.9%). Pooled estimate of any DR-TB prevalence among new TB patients was 20% (95% CI: 16.4−24.4%) while for MDR-TB this was 6% (95% CI: 4.1−9.0%). Among previously treated TB patients, these were 53% (95% CI: 48.3−56.9%) and 34% (95% CI: 30.1−38.3%), respectively. Significant factor for the development of MDR-TB was the history of previous anti-TB treatment (Crude OR=0.13; 95% CI: 0.08−0.20; p= Mono-resistance was detected in 12% (95% CI: 10.2−14.5%) with the highest resistance to streptomycin 6% (95% CI: 4.8−7.9%). Pooled estimate of pre-XDR-TB prevalence rate among MDR-TB patients was 21% (95% CI: 15.2−26.9%). Estimated resistance to ofloxacin, kanamycin, capreomycin and kanamycin and capreomycin were 7% (95% CI: 3.5−10.9%), 2% (95% CI: 0.6−5.1%), 9% (95% CI: 5.8−14.5%), and 3% (95% CI: 0.8−5.8%), respectively. Conclusions The reported prevalence of MDR-TB and pre-XDR-TB are high compared to WHO estimates. Resistance to streptomycin may indicate a high risk of failure for the WHO standard regimen. MDR-TB patients with resistance to either the fluoroquinolone or injectables may have suboptimal response; thus the need for continuous surveillance of TB resistance. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
