PA-184 Lineages diversity and drug resistance of Mycobacterium tuberculosis in Gabon

• Published in: BMJ global health Vol. 8; no. Suppl 10; pp. A47 - A48
• Main Authors: Pacome Agbo Achimi Abdul, Jabar Babatunde, Dibamba Ndanga, Micheska Epola, Edoa, Jean Ronald, Mevyann, Rhett Chester, Ibinda, Guy Mfoumbi, Adegbite, Bayode Romeo, Mebiame, Christopher, Elton, Linzy, McHugh, Tim, Adegnika, Ayola Akim, Alabi, Abraham Sunday, Grobusch, Martin Peter, Lell, Bertrand
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 17.12.2023; BMJ Publishing Group LTD
• Subjects: Abstracts of Poster and e-Poster Presentations; Drug resistance; Tuberculosis; Gabon
• ISSN: 2059-7908
• DOI: 10.1136/bmjgh-2023-EDC.116

BackgroundTuberculosis (TB) is a major public health issue in resource-limited settings, including Gabon, which it is one of the top 30 countries worldwide with a high burden of the disease. Managing multidrug-resistant TB (MDR-TB) in these settings is challenging due to limited access to rapid diagnostics and drug susceptibility testing. Early detection of drug-resistant TB is crucial to controlling transmission of resistant strains and initiating appropriate treatment. The study aimed to determine the proportion and resistance patterns of pre-extensively drug-resistant (Pre-XDR) and extensively drug-resistant (XDR) TB among MDR-TB patients in Gabon and to identify the distribution of their lineages.MethodsIn this cross-sectional study, we collected 92 TB isolates from rifampicin-resistant (RR) patients based on Genexpert. We performed BD MGIT liquid culture and whole-genome sequencing using the MinION according to standard procedures.ResultsOur findings showed that the HIV-TB co-infection rate was 14.1%, and the mean age of the participants was 31.94 years. We observed that 65.2% of patients had MDR-TB, 19.6% had Pre-XDR, 14.1% had RR-TB, and 1.1% had XDR-TB. We identified three main lineages, with Lineage 4 being the most common (81.52%), followed by Lineage 5 (14.13%) and Lineage 2 (3.26%). The dominant genotypes were Cameroon, LAM, Harleem, West Africa 1b, and Beijing, accounting for 47.82%, 19.56%, 17.39%, 6.5%, and 4.3% of cases, respectively.ConclusionOur study reveals a high proportion of Pre-XDR patients, underscoring the need to enhance laboratory capacities to monitor Pre-XDR and XDR-TB patients. This is the first detection of Lineage 2, the most virulent TB strain in Gabon, Further studies are needed to investigate the transmission dynamics of the Lineage 2 TB strain in Gabon. TB programs should prioritize the effective and rational use of second-line drugs for newly diagnosed MDR-TB patients to prevent the emergence of Pre-XDR/XDR-TB strains.