Multidrug- and isoniazid-resistant tuberculosis in three high HIV burden African regions

• Published in: The international journal of tuberculosis and lung disease Vol. 17; no. 8; pp. 1036 - 1042
• Main Authors: Sanchez-Padilla, E., Ardizzoni, E., Sauvageot, D., Ahoua, L., Martin, A., Varaine, F., Adatu-Engwau, F., Akeche, G., Salaniponi, F., Bonnet, M.
• Format: Journal Article
• Language: English
• Published: Paris, France International Union Against Tuberculosis and Lung Disease 01.08.2013; International Union against Tuberculosis and Lung Disease
• Subjects: Adolescent; Adult; Africa South of the Sahara - epidemiology; Antitubercular Agents - pharmacology; Bacterial diseases; Biological and medical sciences; Continents; Cross-Sectional Studies; Drug Resistance, Bacterial; Female; HIV Infections - epidemiology; Human bacterial diseases; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; isoniazid; Isoniazid - pharmacology; Male; Medical sciences; Middle Aged; Mycobacterium tuberculosis - drug effects; Mycobacterium tuberculosis - isolation & purification; Pneumology; Prevalence; Resistance; Rifampin - pharmacology; Survey; Tuberculosis; Tuberculosis - drug therapy; Tuberculosis - epidemiology; Tuberculosis - microbiology; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Multidrug-Resistant - drug therapy; Tuberculosis, Multidrug-Resistant - epidemiology; Tuberculosis, Multidrug-Resistant - microbiology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; Africa South of the Sahara; Kenya; Mycobacterial infection; Multiple resistance; Bacteria; Antituberculous agent; Isoniazid; High; Immunopathology; Treatment resistance; Respiratory disease; Retroviridae; AIDS; Immune deficiency; Lentivirus; resistance; African; Infection; Virus; Survey; Tuberculosis; Mycobacterium tuberculosis; Surveillance; Mycobacteriales; Viral disease; Bacteriosis; Mycobacteriaceae; Actinomycetes; Human immunodeficiency virus; Antibacterial agent
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.12.0842

SETTING: Despite major progress in the surveillance of drug-resistant tuberculosis (TB), data are lacking for many low-resource countries. World Health Organization estimates of multidrug-resistant TB (MDR-TB) rates in Africa are low, and based on very limited data from the African continent.OBJECTIVE: To measure MDR-TB prevalence in sub-Saharan African regions with a high prevalence of human immunodeficiency virus (HIV).METHOD: We conducted three anti-tuberculosis drug resistance surveys in sub-Saharan African regions with high HIV-TB coinfection prevalence: Homa Bay (Kenya), Chiradzulu (Malawi) and West Nile region (Uganda).RESULTS: The prevalence of MDR-TB in new patients was found to be low in the three regions: 1.4% (95%CI 0.2-2.6) in Homa Bay, 2.0% (95%CI 0.4-3.6) in Chiradzulu and 0.6% (95%CI 0.0-1.5) in the West Nile region. We found no significant association between MDR-TB and HIV infection. Nonetheless, ≥10% of the new cases surveyed were resistant to isoniazid (INH).CONCLUSION: The relatively high rate of resistance to INH highlights the need for rapid detection of INH resistance in addition to rifampicin (RMP) resistance, to allow rapid modification of treatment to avoid the acquisition of RMP resistance. Drug resistance should be monitored periodically.