Setting Drug resistance threatens tuberculosis (TB) control, particularly among HIV-infected persons. Objective We surveyed antiretroviral therapy (ART) programs from lower-income countries on prevention and management of drug-resistant TB. Design We used online questionnaires to collect program-level data in 47 ART programs in Southern Africa (14), East Africa (8), West Africa (7), Central Africa (5), Latin America (7) and Asia-Pacific (6 programs) in 2012. Patient-level data were collected on 1,002 adult TB patients seen at 40 of the participating ART programs. Results Phenotypic drug susceptibility testing was available at 36 (77%) ART programs, but only used for 22% of all TB patients. Molecular drug resistance testing was available at 33 (70%) programs and used for 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the whole treatment, 16 (34%) during intensive phase only and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line TB regimens; 18 (38%) reported TB drug shortages. Conclusions Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower income countries. DOT was not always implemented and drug supply was regularly interrupted, which may contribute to the global emergence of drug resistance.

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Introduction: Exclusive breastfeeding (EBF) has the benefits of reduced rates of infectious morbidity and mortality. However, the EBF rate remains low worldwide including in Côte d'Ivoire despite efforts by health authorities. Objective: The study was carried out to describe the knowledge and practices of mothers concerning infant feeding especially with regards to breastfeeding from birth to six months and to identify factors influencing these practices. Methods: This was a descriptive and cross-sectional study conducted over a one-month period (1 st to 31 st August 2014)at a hospital in Abobo-Avocatier. Results: A total of 318 mothers and their infants were recruited. The median (range) age of the mothers was 27 (14-40)years. Over half (64.5%) had some form of formal education, 78.9% lived with a partner while 24.5% were unemployed. The HIV status was unknown in 29.6% of cases. The majority of infants (94%), were born at term through vaginal route (91.5%) and the median (range) age was 74 (2-180) days with a M:F ratio of 1.18. More than half of mothers received advice on breastfeeding (57.2%) mainly by a health care provider (83%). The overall breastfeeding, EBF, predominant breastfeeding and mixed feeding rates were 79.9%, 43.3%, 46.84% and 18.9% respectively. Initiation rate of breastfeeding within the first hour was 29%.The maternal age (p=0.007) and low birth weight of the infant (p=0.023) were significantly associated with EBF. Other factors associated with EBF include the mother's occupation and being married. Conclusion: Despite the high overall rate of breastfeeding in the study, EBF rates and timely initiation of breastfeeding after birth need to be improved. Awareness campaigns need to be strengthened and interventions instituted to scale up optimal breastfeeding practices.

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