Drug-resistant TB prevalence study in 5 health institutions in Haiti
| Autor: | Chloé Masetti, Carole Chedid, Patrice Joseph, Jonathan Hoffmann, Jean W. Pape, Marie-Marcelle Mabou, Laurent Raskine, Elie Maxime Francois, François-Xavier Babin, Oksana Ocheretina, Jean Edouard Mathon, Juliane Gebelin |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Bacterial Diseases
RNA viruses Male Extensively Drug-Resistant Tuberculosis Antitubercular Agents HIV Infections Pathology and Laboratory Medicine Geographical locations 0302 clinical medicine Medical Conditions Immunodeficiency Viruses Drug Resistance Multiple Bacterial Genotype Epidemiology Tuberculosis Multidrug-Resistant Medicine and Health Sciences Prevalence Medicine Mass Screening 030212 general & internal medicine Cause of death Virus Testing education.field_of_study Multidisciplinary Transmission (medicine) Pharmaceutics Coinfection Multi-Drug-Resistant Tuberculosis Actinobacteria Infectious Diseases Medical Microbiology Viral Pathogens Viruses Female Pathogens Rifampin Research Article Adult medicine.medical_specialty Tuberculosis Science 030231 tropical medicine Population Microbial Sensitivity Tests Microbiology 03 medical and health sciences Young Adult Drug Therapy Diagnostic Medicine Internal medicine Retroviruses Isoniazid Humans education Microbial Pathogens Retrospective Studies Caribbean Bacteria business.industry Public health Lentivirus Organisms Biology and Life Sciences HIV Odds ratio Mycobacterium tuberculosis medicine.disease Tropical Diseases Haiti Cross-Sectional Studies North America People and places business |
| Zdroj: | PLoS ONE PLoS ONE, Vol 16, Iss 3, p e0248707 (2021) |
| ISSN: | 1932-6203 |
| Popis: | Objectives Tuberculosis (TB) is the leading infectious cause of death in the world. Multi-drug resistant TB (MDR-TB) is a major public health problem as treatment is long, costly, and associated to poor outcomes. Here, we report epidemiological data on the prevalence of drug-resistant TB in Haiti. Methods This cross-sectional prevalence study was conducted in five health centers across Haiti. Adult, microbiologically confirmed pulmonary TB patients were included. Molecular genotyping (rpoB gene sequencing and spoligotyping) and phenotypic drug susceptibility testing were used to characterize rifampin-resistant MTB isolates detected by Xpert MTB/RIF. Results Between April 2016 and February 2018, 2,777 patients were diagnosed with pulmonary TB by Xpert MTB/RIF screening and positive MTB cultures. A total of 74 (2.7%) patients were infected by a drug-resistant (DR-TB) M. tuberculosis strain. Overall HIV prevalence was 14.1%. Patients with HIV infection were at a significantly higher risk for infection with DR-TB strains compared to pan-susceptible strains (28.4% vs. 13.7%, adjusted odds ratio 2.6, 95% confidence interval 1.5–4.4, P = 0.001). Among the detected DR-TB strains, T1 (29.3%), LAM9 (13.3%), and H3 (10.7%) were the most frequent clades. In comparison with previous spoligotypes studies with data collected in 2000–2002 and in 2008–2009 on both sensitive and resistant strains of TB in Haiti, we observed a significant increase in the prevalence of the drug-resistant MTB Spoligo-International-Types (SIT) 137 (X2 clade: 8.1% vs. 0.3% in 2000–02 and 0.9% in 2008–09, pP = 0.034) and 455 (T1 clade: 5.4% vs 1.6% and 1.1%, P = 0.029). Newly detected spoligotypes (SIT 6, 7, 373, 909 and 1624) were also recorded. Conclusion This study describes the genotypic and phenotypic characteristics of DR-TB strains circulating in Haiti from April 2016 to February 2018. Newly detected MTB clades harboring multi-drug resistance patterns among the Haitian population as well as the higher risk of MDR-TB infection in HIV-positive people highlights the epidemiological relevance of these surveillance data. The importance of detecting RIF-resistant patients, as proxy for MDR-TB in peripheral sites via molecular techniques, is particularly important to provide adequate patient case management, prevent the transmission of resistant strains in the community and to contribute to the surveillance of resistant strains. |
| Databáze: | OpenAIRE |
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