ObjectiveWe evaluated post-vaccination immunity status and describe potential risk factors associated with the lack of response among healthcare workers (HCWs) at a tertiary care hospital in Kigali, Rwanda.ResultsOf 373 HCWs, 291 (78.2%) were female and 81 (21.8%) were male. The mean age of the study participants was 40.2 years (standard deviation [SD], 7.7 years), within a range of 24–41 years. Participants’ mean BMI was 25.4 ± 6.6 kg/m2, with more than half of patients (60.3%) being overweight. 96% received all three doses of vaccination. A total of 36 participants (9.6%) were considered non responders as they did not develop a sufficient anti-HBs response post vaccination. The anti-HBs response was significantly higher in females when compared to males (p = 0.02). Interestingly, there was no significant association between decline in antibody levels with age (p = 0.242) and BMI (p = 0.516) of the participants. The anti-HBs titers were similar in the group of participants who had received two doses and those who had received three doses of the HBV vaccination. Overall the findings of our study provide a basis for testing for anti-HBs in all HCWs post vaccination in Rwanda.

Objective To determine prevalent MDR‐TB genotypes and describe treatment outcome and bacteriology conversion in MDR‐TB patients. Methods Review of laboratory records of 173 MDR‐TB patients from all over Rwanda who initiated treatment under programmatic management of MDR‐TB (PMDT) between 2014 and 2015. Fifty available archived isolates were genotyped by mycobacterial interspersed repetitive units – variable number of tandem repeats (MIRU‐VNTR) genotyping. Result Of the 170 patients whose outcome was known, 114 (66.3%) were cured and 36 (21%) completed the treatment, giving a successful outcome (cured and completed) of 150 (87.3%) patients. Of 20 MDR‐TB patients with unfavourable treatment outcome, 18 died, one failed and one defaulted/stopped treatment. Of the 18 patients who died, 11 (61%) were HIV‐coinfected. The treatment outcome was successful for 93.9% among HIV negative and 81.8% among HIV‐coinfected patients (P = 0.02). Sputum smear conversion occurred in 3, 46, 57 and 78 patients before 2, 3, 4 and 6 months, respectively, with median time of sputum smear and culture conversion at 3 months. The 44 MDR‐TB isolates with MIRU‐VNTR result, showed high genetic diversity with low clustering rate (9.09%) and Uganda II being the most prevalent sub‐family lineage detected in 68.2% of isolates. Beijing family was the least common genotype detected (2.3%, 1 isolate). Conclusion The high success rates for MDR‐TB treatment achieved in Rwanda were comparable to outcomes observed in resource‐rich settings with HIV being an independent risk factor for poor treatment outcome. High genetic diversity and low clustering rate reported here suggest that reactivation of previous disease plays an important role in the transmission of MDR‐TB in Rwanda.

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There is a need to improve antiretroviral options in Africa. This study shows switching from a neviripine-based treatment to co-formulated rilpivirine/emtricitabine/tenofovir disoproxil fumarate in virologically suppressed Rwandans is safe and non-inferior to continued nevirapine-based therapy at 24 weeks.